PCRF Research Alert: Distance Education in 3D

Can new technology improve the performance of disconnected remote learners?

Each month the Prehospital Care Research Forum combs the literature to identify recent studies relevant to EMS education practices. In this segment PCRF board member Megan Corry shares her insight on research that can help bring evidence-based practices to EMS education.

PCRF will host the first annual International Scientific EMS Symposium at EMS World Expo, October 16–20 in Las Vegas. Abstracts are currently being solicited for presentation at the symposium. Click here to learn more. 

Birt J, Moore E, Cowling MA. Piloting Mobile Mixed Reality Simulation in Paramedic Distance Education. IEEE 5th International Conference on Serious Games and Applications for Health (SeGAH), 2017

Whether it’s in “flipped classrooms,” fully online courses or high-fidelity simulation, our students are spending more time during their initial training using technology instead of hearing traditional lecture instruction. With new advances in 3D printers and augmented-reality platforms, the potential for enhancing the distance learning experience is more than just a virtual reality.

One group of researchers in Australia wanted to address inequities in the educational experience voiced by distance-education students who used self-directed online instead of face-to-face instruction during second-year coursework in a paramedic degree program. They found that distance students felt disconnected from the education program compared to face-to-face students during the second-year skills-development courses when opportunities for hands-on skills practice for distance learners were scarce and training was limited to two-dimensional images and text in an online learning platform. They proposed that a complex skill such as direct laryngoscopy and removal of a foreign body with Magill forceps could be learned through a BYOD (bring your own device) mixed-reality simulation approach with enhanced 3D images and tactile feedback through a handheld laryngoscope model.

BYOD allows the student to use her own smart phone mounted to a cap in a hands-free fashion so it suspends in front of the viewer’s eyes. Gaming software is used to create the augmented-reality imaging of the patient’s virtual head and airway. The student can then hold a mock “laryngoscope” (think modified joystick) and interact with the 3D patient head. As the student performs the task, the device provides resistance to mimic the tactile experience of a real patient, while the visual field provides red indicators if the student is not performing a task correctly.

The researchers distributed the materials with instructions to distance-education students one week before they reported for their in-class intensive skills lab. They compared 27 distance-education students who completed the simulation program with a control group of 37 distance-education students who went through standard 2D/text preparation materials prior to reporting to the in-class lab. Participants exposed to simulation received higher scores on four key performance indicators in pretesting than those in the control group. Overall results in summative skills performance, however, did not reveal statistically significant differences in KPI scores between the two groups.

Feedback from student users and instructors indicated the need for improved technology in the tactile component to better mimic the resistance of a real airway. Authors point to the importance of improving this technology to enhance the student’s experience in distance education, particularly in regions where outreach to students in remote areas is necessary for educational equity. While technology is promising, these results must be combined with those of other research that underscores the importance of regular and effective feedback from instructors to improve student outcomes.

Megan Corry, EMT-P, EdD, is the program director and full-time faculty for the City College of San Francisco paramedic program and on the board of advisors of the UCLA Prehospital Care Research Forum.