Development and Evaluation of a Virtual Research Environment to Improve Quality of Care in Overcrowded Emergency Departments: Observational Study

Charles-Henri Houze-Cerfon; Christine Vaissié; Laurent Gout; Bruno Bastiani; Sandrine Charpentier; Dominique Lauque

doi:10.2196/13993

Development and Evaluation of a Virtual Research Environment to Improve Quality of Care in Overcrowded Emergency Departments: Observational Study

JMIR Serious Games. 2019 Aug 8;7(3):e13993. doi: 10.2196/13993.

Authors

Charles-Henri Houze-Cerfon^{1

2

3}, Christine Vaissié⁴, Laurent Gout¹, Bruno Bastiani³, Sandrine Charpentier¹, Dominique Lauque¹

Affiliations

¹ Emergency Department, Toulouse University Hospital, Toulouse, France.
² Institut Toulousain de Simulation en Santé, Toulouse, France.
³ UMR Education, Formation, Travail, Savoir, University Toulouse 2 Jean Jaures, Maison de la Recherche, Toulouse, France.
⁴ Emergency Department, Albi University Hospital, Albi, France.

PMID: 31397292
PMCID: PMC6705008
DOI: 10.2196/13993

Abstract

Background: Despite a wide range of literature on emergency department (ED) overcrowding, scientific knowledge on emergency physicians' cognitive processes coping with overcrowding is limited.

Objective: This study aimed to develop and evaluate a virtual research environment that will allow us to study the effect of physicians' strategies and behaviors on quality of care in the context of ED overcrowding.

Methods: A simulation-based observational study was conducted over two stages: the development of a simulation model and its evaluation. A research environment in emergency medicine combining virtual reality and simulated patients was designed and developed. Afterwards, 12 emergency physicians took part in simulation scenarios and had to manage 13 patients during a 2-hour period. The study outcome was the authenticity of the environment through realism, consistency, and mastering. The realism was the resemblance perceived by the participants between virtual and real ED. The consistency of the scenario and the participants' mastering of the environment was expected for 90% (12/13) of the participants.

Results: The virtual ED was considered realistic with no significant difference from the real world with respect to facilities and resources, except for the length of time of procedures that was perceived to be shorter. A total of 100% (13/13) of participants deemed that patient information, decision making, and managing patient flow were similar to real clinical practice. The virtual environment was well-mastered by all participants over the course of the scenarios.

Conclusions: The new simulation tool, Virtual Research Environment in Emergency Medicine, has been successfully designed and developed. It has been assessed as perfectly authentic by emergency physicians compared with real EDs and thus offers another way to study human factors, quality of care, and patient safety in the context of ED overcrowding.

Keywords: emergency medicine; interprofessional relations; virtual reality.

©Charles-Henri Houze-Cerfon, Christine Vaissié, Laurent Gout, Bruno Bastiani, Sandrine Charpentier, Dominique Lauque. Originally published in JMIR Serious Games (http://games.jmir.org), 08.08.2019.