Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study

Abstract Background How ambulance clinicians (ACs) handle a mass casualty incident (MCI) is essential for the suffered, but the training and learning for the ACs are sparse and they don’t have the possibility to learn without realistic simulation training. In addition, it is unclear what type of dil...

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Main Authors: S. Heldring, V. Lindström, M. Jirwe, J. Wihlborg
Format: Article
Language:English
Published: BMC 2024-09-01
Series:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s13049-024-01255-5
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author S. Heldring
V. Lindström
M. Jirwe
J. Wihlborg
author_facet S. Heldring
V. Lindström
M. Jirwe
J. Wihlborg
author_sort S. Heldring
collection DOAJ
description Abstract Background How ambulance clinicians (ACs) handle a mass casualty incident (MCI) is essential for the suffered, but the training and learning for the ACs are sparse and they don’t have the possibility to learn without realistic simulation training. In addition, it is unclear what type of dilemmas ACs process in their clinical reasoning during an MCI. With virtual reality (VR) simulation, the ACs clinical reasoning can be explored in a systematic way. Therefore, the objective was to explore ambulance clinicians’ clinical reasoning when simulating a mass casualty incident using virtual reality. Methods This study was conducted as an explorative interview study design using chart- stimulated recall technique for data collection. A qualitative content analysis was done, using the clinical reasoning cycle as a deductive matrix. A high-fidelity VR simulation with MCI scenarios was used and participants eligible for inclusion were 11 senior ACs. Results/conclusion All phases of the clinical reasoning cycle were found to be reflected upon by the participants during the interviews, however with a varying richness of analytic reflectivity. Non-analytic reasoning predominated when work tasks followed specific clinical guidelines, but analytical reasoning appeared when the guidelines were unclear or non-existent. Using VR simulation led to training and reflection on action in a safe and systematic way and increased self-awareness amongst the ACs regarding their preparedness for MCIs. This study increases knowledge both regarding ACs clinical reasoning in MCIs, and insights regarding the use of VR for simulation training.
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series Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
spelling doaj-art-0d35431078fd40508aa05458ec1854412025-08-20T02:31:44ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412024-09-0132111010.1186/s13049-024-01255-5Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative studyS. Heldring0V. Lindström1M. Jirwe2J. Wihlborg3Department of Health Promoting Science, Sophiahemmet UniversityDepartment of Health Promoting Science, Sophiahemmet UniversityDepartment of Health Sciences, Swedish Red Cross UniversitySchool of Health and Welfare, Dalarna UniversityAbstract Background How ambulance clinicians (ACs) handle a mass casualty incident (MCI) is essential for the suffered, but the training and learning for the ACs are sparse and they don’t have the possibility to learn without realistic simulation training. In addition, it is unclear what type of dilemmas ACs process in their clinical reasoning during an MCI. With virtual reality (VR) simulation, the ACs clinical reasoning can be explored in a systematic way. Therefore, the objective was to explore ambulance clinicians’ clinical reasoning when simulating a mass casualty incident using virtual reality. Methods This study was conducted as an explorative interview study design using chart- stimulated recall technique for data collection. A qualitative content analysis was done, using the clinical reasoning cycle as a deductive matrix. A high-fidelity VR simulation with MCI scenarios was used and participants eligible for inclusion were 11 senior ACs. Results/conclusion All phases of the clinical reasoning cycle were found to be reflected upon by the participants during the interviews, however with a varying richness of analytic reflectivity. Non-analytic reasoning predominated when work tasks followed specific clinical guidelines, but analytical reasoning appeared when the guidelines were unclear or non-existent. Using VR simulation led to training and reflection on action in a safe and systematic way and increased self-awareness amongst the ACs regarding their preparedness for MCIs. This study increases knowledge both regarding ACs clinical reasoning in MCIs, and insights regarding the use of VR for simulation training.https://doi.org/10.1186/s13049-024-01255-5Ambulance servicesChart-stimulated recall techniqueClinical reasoningDisaster preparednessHigh-fidelity simulationMass casualty incident
spellingShingle S. Heldring
V. Lindström
M. Jirwe
J. Wihlborg
Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Ambulance services
Chart-stimulated recall technique
Clinical reasoning
Disaster preparedness
High-fidelity simulation
Mass casualty incident
title Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study
title_full Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study
title_fullStr Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study
title_full_unstemmed Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study
title_short Exploring ambulance clinicians’ clinical reasoning when training mass casualty incidents using virtual reality: a qualitative study
title_sort exploring ambulance clinicians clinical reasoning when training mass casualty incidents using virtual reality a qualitative study
topic Ambulance services
Chart-stimulated recall technique
Clinical reasoning
Disaster preparedness
High-fidelity simulation
Mass casualty incident
url https://doi.org/10.1186/s13049-024-01255-5
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AT mjirwe exploringambulancecliniciansclinicalreasoningwhentrainingmasscasualtyincidentsusingvirtualrealityaqualitativestudy
AT jwihlborg exploringambulancecliniciansclinicalreasoningwhentrainingmasscasualtyincidentsusingvirtualrealityaqualitativestudy