Interdisciplinary CommunicationNCT04330924
A Comparison Between Physical and Virtual Simulation: A Randomized Controlled Trial
A study testing Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE) in people with Interdisciplinary Communication, run by National University of Singapore at 1 site in Singapore.
Trial summary
Nurse-physician communication skills can be improve through inter-professional team training. Simulation is often used to conduct these training. However, constraints to conduct these sessions such as scheduling and logistic arrangements have been widely reported. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Interdisciplinary Communication
- What is being tested?
- Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 120 participants
- Where
- 1 siteSingapore
- Study dates
- 1 Jul 2018to 31 Dec 2019
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Full time students undertaking National University of Singapore's
- Third or fourth year Bachelor of Science (Nursing)
- Third or fourth year Bachelor of Medicine \& Bachelor of Surgery
- Completed acute care management modules
Who cannot join
- Does not voluntarily agree to join the study
- Does not want their performance to be video-recorded
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Nurse-Physician Communication Team Training in Virtual Reality Versus Live Simulations: Randomized Controlled Study
Nurse-physician communication skills can be improve through inter-professional team training. Simulation is often used to conduct these training. However, constraints to conduct these sessions such as scheduling and logistic arrangements have been widely reported. Thus with the advancement of technology in education, the use of virtual environment to conduct the team training is being explored and evaluated.
Read the detailed description
All recruited participants underwent a 3-hour nurse-physician communication training prior to the simulation session. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) curriculum and pre-learning videos were introduced to the participants. Pre-test questionnaires were administered after the training. Participants were then randomized to the control (live simulation) or intervention group (virtual simulation).
Intervention group participants will undergo a virtual simulation session training via the multi-user virtual world by logging in into the 3D virtual environment while participants in the control group performed the simulations in a physical simulated ward setting. Each pair of 1 medical student and 1 nursing student participate in two role-playing simulation scenarios (15-20 minutes each) along with a facilitator who will provide a debrief (30-minutes). Prior to the simulation, participants were given a smart-watch to monitor their physiological parameters such as heart rate. Post-test questionnaires were administered after the simulation sessions.
After the simulation training, a 30-minutes team-based assessments were conducted based on a inter-professional bedside care scenario in pairs of one medical and one nursing student within their randomized group. The assessments were video recorded for evaluation by assessors who are blinded to the groupings. All participants were then invited to complete a follow-up questionnaire 2 months after the simulation training.
- Conditions
- Interdisciplinary Communication
- Being tested
- Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE)
- Keywords
- team training, virtual reality, simulation, nurse-physician communication
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE)Other
3D virtual hospital environment where participants can perform physical and social interaction and presence using avatars.
| Study group | Role | What they receive |
|---|---|---|
| Virtual Reality | Experimental | 3D avatar in a virtual simulation environment Receives: Other: Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE) |
| Live Simulation | No intervention | Live-based simulation in a simulation ward |
What is being measured
The primary outcome is the main question the study is designed to answer.
Demographics
Collection of participant demographic data.
Measured: Baseline
Communication skill performance
Participants nurse-doctor communication skill was measured using a validated team communication scale that was self-developed. It is a 7-item checklist with a 5-point scale. The score ranges from 5 to 35 with higher score indicating better nurse-doctor communication performance.
Measured: Post-test (immediately after simulation assessment)
Baseline (Attitudes Toward Interprofessional Health Care Team)
Measurement of participants' attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Measured: Pre-test
Post-test (Change of Attitudes Toward Interprofessional Health Care Team from baseline)
Measurement of participants' attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Measured: Post-test (immediately after simulation training)
Follow-up (Change of Attitudes Toward Interprofessional Health Care Team from baseline and post-test)
Measurement of participants attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Measured: Follow-up (2-months after simulation training)
Baseline (Interprofessional Socialization and Valuing Scale)
Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Measured: Pre-test
Post-test (Change of Interprofessional Socialization and Valuing Scale from baseline)
Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Measured: Post-test (immediately after simulation training)
Follow-up (Change of Interprofessional Socialization and Valuing Scale from baseline and post-test)
Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Measured: Follow-up (2-months after simulation training)
Pulse rate
Stress measurement parameter using a continuous monitoring smart watch
Measured: Pre-test
Pulse rate (Change of parameter from baseline)
Stress measurement parameter using a continuous monitoring smart watch
Measured: Post-test (immediately after simulation training)
Blood pressure (diastolic & systolic)
Stress measurement parameter using a sphygmomanometer
Measured: Pre-test
Blood pressure (diastolic & systolic) (Change of parameter from baseline)
Stress measurement parameter using a sphygmomanometer
Measured: Post-test (immediately after simulation training)
Baseline (State-Trait Anxiety Inventory)
Measurement of participants state anxiety were measured using the 20-items State-Trait Anxiety Inventory questionnaire using a 4 point likert scale (almost never-almost always). The score ranges from 20 to 80 with higher score indicating higher sense of anxiety.
Measured: Pre-test
Post-test (Change of State-Trait Anxiety Inventory from baseline)
Measurement of participants state anxiety were measured using the 20-items State-Trait Anxiety Inventory questionnaire using a 4 point likert scale (almost never-almost always). The score ranges from 20 to 80 with higher score indicating higher sense of anxiety.
Measured: Post-test (immediately after simulation training)
Baseline (Confidence and self-efficacy)
Measurement of participants confidence and self-efficacy was measured using a 5-items self-efficacy questionnaire through a 10-point likert scale ranging from scores ranging from 5 to 50 with higher score indicating better self-efficacy in their ability in contributing to patient-centered care in a multidisciplinary team.
Measured: Pre-test
Post-test (Change of Confidence and self-efficacy from baseline)
Measurement of participants confidence and self-efficacy was measured using a 5-items self-efficacy questionnaire through a 10-point likert scale ranging from scores ranging from 5 to 50 with higher score indicating better self-efficacy in their ability in contributing to patient-centered care in a multidisciplinary team.
Measured: Post-test (immediately after simulation training)
Baseline (Student Stereotype Rating)
Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high).
The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.
Measured: Pre-test
Post test (Change of Student Stereotype Rating from baseline)
Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high). The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.
Measured: Post-test (immediately after simulation training)
Follow up (Change of Student Stereotype Rating from baseline and post test)
Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high). The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.
Measured: Follow-up (2-months after simulation training)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Apr 2020
- Study start1 Jul 2018
- Primary completion31 Dec 2019
- Study completion31 Dec 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Interdisciplinary CommunicationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 120 participants (actual)
Sponsor and investigators
- Lead sponsor
- National University of Singapore
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Liaw Sok Ying, National University of Singapore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04330924
- Sponsor's protocol ID
- S-17-107
- Status last verified
- Apr 2020
- First submitted
- 26 Mar 2020
- Last updated
- 3 Apr 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Liaw SY, Sutini, Chua WL, Tan JZ, Levett-Jones T, Ashokka B, Te Pan TL, Lau ST, Ignacio J. Desktop Virtual Reality Versus Face-to-Face Simulation for Team-Training on Stress Levels and Performance in Clinical Deterioration: a Randomised Controlled Trial. J Gen Intern Med. 2023 Jan;38(1):67-73. doi: 10.1007/s11606-022-07557-7. Epub 2022 May 2.
PubMed 35501626Liaw SY, Ooi SW, Rusli KDB, Lau TC, Tam WWS, Chua WL. Nurse-Physician Communication Team Training in Virtual Reality Versus Live Simulations: Randomized Controlled Trial on Team Communication and Teamwork Attitudes. J Med Internet Res. 2020 Apr 8;22(4):e17279. doi: 10.2196/17279.
PubMed 32267235
Study at a glance
From the registry record, last updated by the sponsor on 3 Apr 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Nurse-Physician Communication Team Training in Virtual Reality Versus Live Simulations: Randomized Controlled Study
- ClinicalTrials.gov ID
- NCT04330924
- Acronym / sponsor ID
- S-17-107
- Conditions
- Interdisciplinary Communication
- Keywords
- team training, virtual reality, simulation, nurse-physician communication
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 120 participants (actual)
- Lead sponsor
- National University of SingaporeUniversity, hospital or other
- Study start
- 1 Jul 2018 (actual)
- Primary completion
- 31 Dec 2019 (actual)
- Study completion
- 31 Dec 2019 (actual)
- First posted
- 2 Apr 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Nurse-physician communication skills can be improve through inter-professional team training. Simulation is often used to conduct these training. However, constraints to conduct these sessions such as scheduling and logistic arrangements have been widely reported. Thus with the advancement of technology in education, the use of virtual environment to conduct the team training is being explored and evaluated.
Detailed description
All recruited participants underwent a 3-hour nurse-physician communication training prior to the simulation session. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) curriculum and pre-learning videos were introduced to the participants. Pre-test questionnaires were administered after the training. Participants were then randomized to the control (live simulation) or intervention group (virtual simulation).
Intervention group participants will undergo a virtual simulation session training via the multi-user virtual world by logging in into the 3D virtual environment while participants in the control group performed the simulations in a physical simulated ward setting. Each pair of 1 medical student and 1 nursing student participate in two role-playing simulation scenarios (15-20 minutes each) along with a facilitator who will provide a debrief (30-minutes). Prior to the simulation, participants were given a smart-watch to monitor their physiological parameters such as heart rate. Post-test questionnaires were administered after the simulation sessions.
After the simulation training, a 30-minutes team-based assessments were conducted based on a inter-professional bedside care scenario in pairs of one medical and one nursing student within their randomized group. The assessments were video recorded for evaluation by assessors who are blinded to the groupings. All participants were then invited to complete a follow-up questionnaire 2 months after the simulation training.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Virtual Reality | Experimental | Other: Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE)3D avatar in a virtual simulation environment |
| Live Simulation | No intervention | –Live-based simulation in a simulation ward |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Full time students undertaking National University of Singapore's
- Third or fourth year Bachelor of Science (Nursing)
- Third or fourth year Bachelor of Medicine \& Bachelor of Surgery
- Completed acute care management modules
Key exclusion criteria (2 listed)
- Does not voluntarily agree to join the study
- Does not want their performance to be video-recorded
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE)3D virtual hospital environment where participants can perform physical and social interaction and presence using avatars. | Other | Virtual Reality |
Primary outcome
Demographics
Time frame: Baseline
Collection of participant demographic data.
Communication skill performance
Time frame: Post-test (immediately after simulation assessment)
Participants nurse-doctor communication skill was measured using a validated team communication scale that was self-developed. It is a 7-item checklist with a 5-point scale. The score ranges from 5 to 35 with higher score indicating better nurse-doctor communication performance.
Baseline (Attitudes Toward Interprofessional Health Care Team)
Time frame: Pre-test
Measurement of participants' attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Post-test (Change of Attitudes Toward Interprofessional Health Care Team from baseline)
Time frame: Post-test (immediately after simulation training)
Measurement of participants' attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Follow-up (Change of Attitudes Toward Interprofessional Health Care Team from baseline and post-test)
Time frame: Follow-up (2-months after simulation training)
Measurement of participants attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Baseline (Interprofessional Socialization and Valuing Scale)
Time frame: Pre-test
Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Post-test (Change of Interprofessional Socialization and Valuing Scale from baseline)
Time frame: Post-test (immediately after simulation training)
Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Follow-up (Change of Interprofessional Socialization and Valuing Scale from baseline and post-test)
Time frame: Follow-up (2-months after simulation training)
Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Pulse rate
Time frame: Pre-test
Stress measurement parameter using a continuous monitoring smart watch
Pulse rate (Change of parameter from baseline)
Time frame: Post-test (immediately after simulation training)
Stress measurement parameter using a continuous monitoring smart watch
Blood pressure (diastolic & systolic)
Time frame: Pre-test
Stress measurement parameter using a sphygmomanometer
Blood pressure (diastolic & systolic) (Change of parameter from baseline)
Time frame: Post-test (immediately after simulation training)
Stress measurement parameter using a sphygmomanometer
Baseline (State-Trait Anxiety Inventory)
Time frame: Pre-test
Measurement of participants state anxiety were measured using the 20-items State-Trait Anxiety Inventory questionnaire using a 4 point likert scale (almost never-almost always). The score ranges from 20 to 80 with higher score indicating higher sense of anxiety.
Post-test (Change of State-Trait Anxiety Inventory from baseline)
Time frame: Post-test (immediately after simulation training)
Measurement of participants state anxiety were measured using the 20-items State-Trait Anxiety Inventory questionnaire using a 4 point likert scale (almost never-almost always). The score ranges from 20 to 80 with higher score indicating higher sense of anxiety.
Baseline (Confidence and self-efficacy)
Time frame: Pre-test
Measurement of participants confidence and self-efficacy was measured using a 5-items self-efficacy questionnaire through a 10-point likert scale ranging from scores ranging from 5 to 50 with higher score indicating better self-efficacy in their ability in contributing to patient-centered care in a multidisciplinary team.
Post-test (Change of Confidence and self-efficacy from baseline)
Time frame: Post-test (immediately after simulation training)
Measurement of participants confidence and self-efficacy was measured using a 5-items self-efficacy questionnaire through a 10-point likert scale ranging from scores ranging from 5 to 50 with higher score indicating better self-efficacy in their ability in contributing to patient-centered care in a multidisciplinary team.
Baseline (Student Stereotype Rating)
Time frame: Pre-test
Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high). The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.
Post test (Change of Student Stereotype Rating from baseline)
Time frame: Post-test (immediately after simulation training)
Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high). The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.
Follow up (Change of Student Stereotype Rating from baseline and post test)
Time frame: Follow-up (2-months after simulation training)
Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high). The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Apr 2020.
- Derived from this study: PubMed 35501626Liaw SY, Sutini, Chua WL, Tan JZ, Levett-Jones T, Ashokka B, Te Pan TL, Lau ST, Ignacio J. Desktop Virtual Reality Versus Face-to-Face Simulation for Team-Training on Stress Levels and Performance in Clinical Deterioration: a Randomised Controlled Trial. J Gen Intern Med. 2023 Jan;38(1):67-73. doi: 10.1007/s11606-022-07557-7. Epub 2022 May 2.
- Derived from this study: PubMed 32267235Liaw SY, Ooi SW, Rusli KDB, Lau TC, Tam WWS, Chua WL. Nurse-Physician Communication Team Training in Virtual Reality Versus Live Simulations: Randomized Controlled Trial on Team Communication and Teamwork Attitudes. J Med Internet Res. 2020 Apr 8;22(4):e17279. doi: 10.2196/17279.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE) in people with Interdisciplinary Communication, run by National University of Singapore at 1 site in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Apr 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Demographics (time frame: Baseline). The study lists 19 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04330924, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Apr 2020.