Immersive education: virtual reality in clinical audiology: a pilot study of the effectiveness of a new patient simulator program on audiology students’ performance on case history tasks

Purpose: Hearing loss is a common problem worldwide, and there is an ever- increasing need for more audiologists to be trained. Unfortunately, audiology students cannot always get the clinical experience they need during training. Virtual reality involving computer-based simulation of real-life training experiences is one way of compensating for this. While there are several virtual audiometers available for student use, few of these include the vital case history component. This study sought to develop an interactive virtual patient that includes this component, and to objectively measure the effect of training with this software on student performance. Method: Development of the Patient Simulator Program (PSP) took place in two phases – Phase One involved development of audiometric information and a brief case history summary for 25 patient cases, and Phase Two involved development of comprehensive case histories for these and identification of triggering phrases and keywords for eliciting each piece of information from the virtual patient. Twelve first year audiology students were recruited from the University of Canterbury and divided into matched groups based on their pre-test scores. An alternating treatment design across groups was used to evaluate participants on their verbal and written accuracy, experience, confidence, and efficiency scores on case history tasks. Results: A significant difference was found in verbal accuracy scores between groups at the mid-way assessment point (following simulator training), but not for written accuracy. Differences between groups were not significant at all assessment points for efficiency and experience measures. Confidence gains were greater for the second group to train with the simulator than the first, while performance gains were greater for the first group. Conclusion: These findings support the evidence that simulation training can enhance student’s skills, and provide the first objective evidence for the benefits of training for case history tasks with an interactive virtual patient. While the effect size was small, these findings are a promising springboard for future research into this area. While the PSP is not adequate to replace real clinical encounters, it has potential as an adjunct to the current training program