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      Implementation of Virtual Reality in Health Professions Education: Scoping Review

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          Abstract

          Background

          Virtual reality has been gaining ground in health professions education and may offer students a platform to experience and master situations without endangering patients or themselves. When implemented effectively, virtual reality technologies may enable highly engaging learning activities and interactive simulations. However, implementation processes present challenges, and the key to successful implementation is identifying barriers and facilitators as well as finding strategies to address them.

          Objective

          This scoping review aimed to identify the literature on virtual reality implementation in health professions education, identify barriers to and facilitators of implementation, and highlight gaps in the literature in this area.

          Methods

          The scoping review was conducted based on the Joanna Briggs Institute Evidence Synthesis methodologies. Electronic searches were conducted in the Academic Search Elite, Education Source, and CINAHL databases on January 5, 2022, in Google Scholar on February 2 and November 18, 2022, and in PubMed database on November 18, 2022. We conducted hand searches of key items, reference tracking, and citation tracking and searches on government webpages on February 2, 2022. At least 2 reviewers screened the identified literature. Eligible studies were considered based on predefined inclusion criteria. The results of the identified items were analyzed and synthesized using qualitative content analysis.

          Results

          We included 7 papers and identified 7 categories related to facilitators of and barriers to implementation—collaborative participation, availability, expenses, guidelines, technology, careful design and evaluation, and training—and developed a model that links the categories to the 4 constructs from Carl May’s general theory of implementation. All the included reports provided recommendations for implementation, including recommendations for careful design and evaluation, training of faculty and students, and faculty presence during use.

          Conclusions

          Virtual reality implementation in health professions education appears to be a new and underexplored research field. This scoping review has several limitations, including definitions and search words, language, and that we did not assess the included papers’ quality. Important implications from our findings are that ensuring faculty’s and students’ competence in using virtual reality technology is necessary for the implementation processes. Collaborative participation by including end users in the development process is another factor that may ensure successful implementation in higher education contexts. To ensure stakeholders’ motivation and potential to use virtual reality, faculty and students could be invited to participate in the development process to ensure that the educational content is valued. Moreover, technological challenges and usability issues should be resolved before implementation to ensure that pedagogical content is the focus. This accentuates the importance of piloting, sufficient time resources, basic testing, and sharing of experiences before implementation.

          International Registered Report Identifier (IRRID)

          RR2-10.2196/37222

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          Most cited references54

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          The theory of planned behavior

          Icek Ajzen (1991)
          Organizational Behavior and Human Decision Processes, 50(2), 179-211
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            PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

            Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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              The qualitative content analysis process.

              This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
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                Author and article information

                Contributors
                Journal
                JMIR Med Educ
                JMIR Med Educ
                JME
                JMIR Medical Education
                JMIR Publications (Toronto, Canada )
                2369-3762
                2023
                24 January 2023
                : 9
                : e41589
                Affiliations
                [1 ] Department of Health Faculty of Health Studies VID Specialized University Stavanger Norway
                [2 ] Department of Nursing Faculty of Health Studies VID Specialized University Bergen Norway
                [3 ] Department of Health and Nursing Science Faculty of Social and Health Sciences Inland Norway University of Applied Sciences Elverum Norway
                Author notes
                Corresponding Author: Silje Stangeland Lie siljes.lie@ 123456vid.no
                Author information
                https://orcid.org/0000-0002-6530-3710
                https://orcid.org/0000-0002-5375-5218
                https://orcid.org/0000-0002-4231-9269
                https://orcid.org/0000-0002-1759-3872
                https://orcid.org/0000-0001-6315-1111
                Article
                v9i1e41589
                10.2196/41589
                9906320
                36692934
                0922fc61-cd16-4b28-887e-1199dd87f59b
                ©Silje Stangeland Lie, Nikolina Helle, Nina Vahl Sletteland, Miriam Dubland Vikman, Tore Bonsaksen. Originally published in JMIR Medical Education (https://mededu.jmir.org), 24.01.2023.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Education, is properly cited. The complete bibliographic information, a link to the original publication on https://mededu.jmir.org/, as well as this copyright and license information must be included.

                History
                : 1 August 2022
                : 17 November 2022
                : 7 December 2022
                : 23 December 2022
                Categories
                Review
                Review

                implementation,virtual reality,higher education,medical education,health professions education,continuing education,scoping review,health professional,technology

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