Using virtual reality to support community based medical education

Simulation-based education (SBE) provides a safe solution to improve clinical competencies. Community-based SBE aims to equip students to understand the environment most patients will be seen in. However, most community scenarios are difficult to recreate in a reproducible fashion at scale. There are also capacity challenges sourcing community placements. Virtual Reality (VR) simulation offers a scalable way to immerse students in realistic home environments, replicating the complexities of real-life patient interactions by supplementing, but not replacing, clinical placements. Most research on the effectiveness of VR simulation in SBE focusses on secondary care-based technical-skills training: The effectiveness and engagement with VR in a local community setting has not been fully investigated.

This study aims to test the feasibility of a 360-degree VR community-based focused scenario, and to explore the experience (e.g. digital competence and sense of presence) from the perspective of undergraduate medical students and educators.

We conducted a convergent mixed-methods, evaluative exploratory research study design to evaluate educators (n=12) and students’ (n=45) experiences of a simulated community general practice (GP) home visit experience in East Scotland using VR. Semi-structured focus group interviews were held with 12 educators and 31 undergraduate medical students. Students’ experiences were quantitively explored to examine relationships between VR interest, prior VR experience, digital competence, and VR frequency. 

Students with higher VR interest were more engaged primarily when they experienced a strong sense of presence (e.g., immersion). Their prior VR experience is linked to digital competence and more frequent VR use, yet it did not directly predict engagement or presence. Additionally, students' digital skills alone do not determine their experience in VR environments, whereas the presence within VR and engagement with VR were associated with its effectiveness. Educators valued the immersion and educational value of the scenario, but there were technical limitations.

Community based SBE utilising virtual reality can be an appropriate means of supplementing clinical placements, however, to enhance students’ experience scenarios need to be designed to ensure interactivity and sense of VR presence, increasing engagement and effectiveness. Prior digital competence is not a prerequisite in determining the effectiveness of VR simulation in this setting.