PERTINENCE PÉDAGOGIQUE DE LA SIMULATION CLINIQUE PAR RÉALITÉ VIRTUELLE DANS LA FORMATION COLLÉGIALE SOINS PRÉHOSPITALIERS D’URGENCE 181.A0

Research Issue: Recent public data indicates that college students of the Pre-Hospital Emergency Care 181.A0 Program lack exposure to authentic learning opportunities, which could reduce their ability to fully acquiring certain prescribed skills. In spite of the program’s excellent success rate, between 2014 and 2018, almost 41% of candidates to the paramedical profession failed the knowledge assessment required for entry into the Programme national d’intégration clinique (PNIC) on their first attempt. The PNIC is a training-assessment program that enables successful candidates to become practicing paramedics in Québec. One should note that the PNIC’s knowledge assessment is a high-stakes test that requires successful completion of two distinct isochron exams, one theoretical, the other, practical. Most PNIC test failures are caused by not passing the practical exam. This led us to think that the methods used to teach clinical protocols and interventions in the 181.A0 Program do not enable students to optimally meet the requirements of the PNIC practical exam. As a solution to this issue, the immersive use of clinical simulations in a virtual reality environment or VR-sim, based on authentic interventions that paramedics perform daily, represents an innovative educational method that allows students to contextualize the practical training received in the Pre-Hospital Emergency Care Program. There is reasonable ground to believe that this educational solution would contribute to optimizing the preparation of students wanting to become paramedics and help them meet the professional requirements of the PNIC practical exam.
Objectives: This research had two fundamental objectives: 1) Conceptualize, create and test two virtual clinical simulation environments that would be used for the practical training of fifth-session Pre-Hospital Emergency Care students and the continuing professional development of paramedics. 2) Assess the perception that these fifth-session students and paramedics have of the efficiency of immersive clinical simulation in a virtual reality environment as a teaching method.
Research Questions: In order to objectify the perception that students and paramedics have of the efficiency of immersive virtual clinical simulations (VR-sim) as a teaching method, this research had to answer the following four questions: 1) What perception do students and paramedics have of the educational design of VR-sim? 2) What perception do they have of good teaching practices related to VR-sim learning? 3) What level of satisfaction do they feel toward their VR-sim learning? 4) What level of confidence do they have in their VR-sim learning?Methodology: This exploratory and multicentric research is based on a mixed research methodology [i.e., an explanatory sequential mixed method design (QUAN → qual), based on quantative and qualitative data]. The data was gathered from a convenience sample of 35 subjects (20 fifth-semester students taking the 181-540-SF – Intégration 1 Course as part of the regular Pre-Hospital Emergency Care 181.A0 Program, and 15 practicing paramedics). The quantitative part of the research was based on a pre-experimental post-test protocole. The qualititative part was carried out by doing a thematic content analysis.
Results: The quantitive results obtained from four measurement tools suggest that the research subjects liked the pedagogical design of the VR-sim, as well as the teaching methods that the facilitators used during the activity. Results also showed that the subjects were quite satisfied with what they had learned during the VR-sim activity and were confident that the new knowledge that they had acquired would help them solve paramedical issues. There was no statistical difference between the scores of the fifth-session students and those of the paramedics on the four measurements. Regarding the qualitative results, the thematic content analysis allowed us to identify seven (7) emerging themes: 1) Realism of the simulation environment and closeness to the task; 2) Realism of the clinical situation; 3) Adaptation period; 4) Opportunities for action and interaction; 5) Limitiations of the scenarios; 6) Decision-making; and finally 7) Teacher support.
Conclusion: The results of this reseach are unequivocal and suggest that the authentic learning produced by immersive virtual clinical environments was appreciated by both student and paramedic subjects. All in all, there are reasons to believe that the knowledge and skills acquired in virtual clinical simulations will optimize the ability of students hoping to become paramedics to pass the knowledge assessment test required for entry into the Programme national d’intégration clinique.