Virtual vs. Traditional CPR Training: Effects on Stress

Oulu University Hospital

Status: Enrolling

Conditions: Stress and Anxiety; Heart Rate Variability, Biomarker of Stress

Treatments: Other: Medical education, basic life support training

Study type: Interventional

Funder types: Other

Identifiers

NCT07147322

162/2024

Details and patient eligibility

About

This medical education study investigates stress levels among undergraduate medical students during basic life support (BLS) training. It compares traditional face-to-face teaching session with virtual reality (VR) training simulating a resuscitation scenario in a public place. We will measure heart rate, heart rate variability, and self-reported stress to assess acute stress responses. The study also examines physical sensations related to VR, the realism of the virtual environment, and the suitability of VR for BLS training.

Full description

Cardiac arrest is a major cause of mortality, with survival depending heavily on timely and effective cardiopulmonary resuscitation (CPR). Basic life support (BLS) training teaches recognition of cardiac arrest, calling for help, providing chest compressions and ventilations, and using an automated external defibrillator (AED). For healthcare students, regular BLS training is essential but often limited by time, resources, and staff availability. Simulation-based training provides safe practice opportunities, but traditional methods can be resource-intensive.

Virtual reality (VR) offers an alternative, enabling immersive, interactive training with lower resource requirements. VR can simulate realistic resuscitation scenarios in varied environments, potentially increasing engagement, situational awareness, and learning outcomes. However, VR may also induce physical symptoms such as nausea or dizziness, and its effectiveness compared with conventional training remains under investigation.

This pilot study compares conventional face-to-face BLS training with VR-based training delivered via head-mounted displays simulating a public cardiac arrest. The primary objective is to evaluate stress responses between the two methods, measured physiologically by heart rate variability (HRV) and psychologically by validated stress and workload questionnaires. Secondary objectives are to assess VR-related physical symptoms, the perceived realism and usability of the VR environment, and its suitability as a BLS teaching method.

The VR environment replicates a public setting with bystanders and distractions. Compressions are performed on a manikin mapped to a virtual patient, with real-time feedback on depth and rate. A virtual AED is integrated into the simulation.

Sixty first- or second-year medical students will be randomized to VR-based or conventional manikin-based BLS training (30 per group). Exclusion criteria include pregnancy, prior healthcare experience, and BLS training within the past six months. Previous VR experience will be recorded.

Physiological stress will be recorded using a three-lead surface ECG (Bittium Faros 180, Finland), providing continuous heart rate and HRV data. Approximately three hours of data will be collected, including baseline rest, training, and post-session recovery.

Participants will complete pre- and post-session questionnaires (STAI (state anxiety; NASA-TLX (task load); System Usability Scale (SUS); Simulation Sickness Questionnaire (SSQ); Simulation Design Scale (SDS): Credibility/Presence measures) All surveys will be completed electronically. A standard debrief follows each session.

The study is approved by the regional ethics committee and conducted under GDPR and the Declaration of Helsinki. Participation is voluntary with informed consent. VR may cause mild symptoms such as nausea or dizziness; sessions will be stopped if symptoms become limiting. Data are pseudonymized and securely stored.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 30 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Volunteers (18-30 years old) will be recruited from first- and second-year medical students
• Participants must be healthy young individuals with no known heart disease, normal physical performance capacity, and no current physical limitations that would affect the ability to perform chest compressions.

Exclusion criteria

• Pregnant individuals will not be included
• Individuals with previous healthcare experience will not be included.
• Participants must not have received basic life support training within the past six months.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

Face-to-face Basic Life Support educational training

Other group

Description:

Traditional face-to-face Basic Life Support training for undergraduate medical students. Education based on European resuscitation council guidelines. Education period includes info and session lasting aprox. 30min/participant.

Treatment:

Other: Medical education, basic life support training

Basic Life Support training for undergraduate medical students in virtual reality environment

Other group

Description:

Basic Life Support training for undergraduate medical students in virtual reality environment. Education based on European resuscitation council guidelines. Education period includes info and session lasting aprox. 30min/participant.

Treatment:

Other: Medical education, basic life support training