Observing the stages of bystander intervention in virtual reality simulation

作     者：David G. Buckler Alfredo Almodovar Jr Paul Snobelen Benjamin S. Abella Audrey Blewer Marion Leary 

作者机构：Center for Resuscitation Science University of Pennsylvania Philadelphia PA 19104 USA Peel Regional Paramedic Service 1600 Bovaird Dr. E Brampton ON L6R 3S8 Canada Department of Community & Family Medicine Duke University Medical Center DUMC 2914 Durham NC 27710 USA School of Nursing University of Pennsylvania 418 Guardian Drive Philadelphia PA 19104 USA 

出 版 物：《World Journal of Emergency Medicine》 (世界急诊医学杂志（英文）)

年 卷 期：2019年第10卷第3期

页      面：145-151页

核心收录：

学科分类：10[医学] 

基　　金：supported by the Medtronic Foundation the Laerdal Foundation 

主　　题：Virtual reality Bystander intervention Emergency preparedness 

摘      要：BACKGROUND: Understanding bystander reactions to an emergency is an important component of effective training. Four stages of bystander intervention (BI) have been previously described: noticing the situation as a problem, interpreting when it is appropriate to intervene, recognizing personal responsibility to intervene, and knowing how to intervene. Using virtual reality (VR) to simulate emergencies such as sudden cardiac arrest (SCA) can be used to study these stages. METHODS: In a secondary analysis of an observational cohort study, we analyzed bystander self-effi cacy for stages of BI before and after simulated SCA. Each subject participated in a singleplayer, immersive, VR SCA scenario. Subjects interacted with simulated bystanders through voice commands (“call 911,“get an AED). Actions taken in scenario, like performing CPR, were documented. Scenario BI actions were compared based on dichotomized comfort/discomfort. RESULTS: From June 2016 to June 2017, 119 subjects participated. Average age was 37±14 years, 44% were female and 46% reported CPR training within 2 years. During the scenario, 98%“noticed the event and “interpreted it as a problem, 78%“took responsibility, and 54%“possessed the necessary skills. Self-effi cacy increased from pre- to post-scenario: noticing the event increased from 80% to 96%;interpreting as a problem increased from 86% to 97%;taking responsibility increased from 56% to 93%;possessing necessary skills increased from 47% to 63%(P0.001). CONCLUSION: Self-efficacy to respond to an SCA event increased pre- to post-scenario. Bystanders who reported feeling comfortable “taking responsibility to intervene during an emergency were more likely to take action during a simulated emergency.