The effectiveness of virtual reality training on knowledge, skills and attitudes of health care professionals and students in assessing and treating mental health disorders: a systematic review

BACKGROUND

Virtual reality (VR) training can enhance health professionals' learning. However, there are ambiguous findings on the effectiveness of VR as an educational tool in mental health. We therefore reviewed the existing literature on the effectiveness of VR training on health professionals' knowledge, skills, and attitudes in assessing and treating patients with mental health disorders.

METHODS

We searched MEDLINE, PsycINFO (via Ovid), the Cochrane Library, ERIC, CINAHL (on EBSCOhost), Web of Science Core Collection, and the Scopus database for studies published from January 1985 to July 2023. We included all studies evaluating the effect of VR training interventions on attitudes, knowledge, and skills pertinent to the assessment and treatment of mental health disorders and published in English or Scandinavian languages. The quality of the evidence in randomized controlled trials was assessed with the Cochrane Risk of Bias Tool 2.0. For non-randomized studies, we assessed the quality of the studies with the ROBINS-I tool.

RESULTS

Of 4170 unique records identified, eight studies were eligible. The four randomized controlled trials were assessed as having some concern or a high risk of overall bias. The four non-randomized studies were assessed as having a moderate to serious overall risk of bias. Of the eight included studies, four used a virtual standardized patient design to simulate training situations, two studies used interactive patient scenario training designs, while two studies used a virtual patient game design. The results suggest that VR training interventions can promote knowledge and skills acquisition.

CONCLUSIONS

The findings indicate that VR interventions can effectively train health care personnel to acquire knowledge and skills in the assessment and treatment of mental health disorders. However, study heterogeneity, prevalence of small sample sizes, and many studies with a high or serious risk of bias suggest an uncertain evidence base. Future research on the effectiveness of VR training should include assessment of immersive VR training designs and a focus on more robust studies with larger sample sizes.

TRIAL REGISTRATION

This review was pre-registered in the Open Science Framework register with the ID-number Z8EDK.

Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities

Background

Weight bias exhibited by health care students may continue into their future practice, compromising the provision of care that people living with overweight or obesity receive. This highlights the need to comprehensively examine the extent to which weight bias is present among health care students and the factors that may be associated with students' weight bias.

Methods

In this cross-sectional study, Australian university students enrolled in health care courses were invited via social media advertisements, snowball and convenience sampling, and by making direct contact with universities to complete an online survey. Students provided demographic information including discipline of study, perceived weight status, and state of residence. Students then completed several measures which assessed their explicit and implicit weight bias, and empathy. Descriptive statistics established the presence of explicit and implicit weight bias, and ANCOVAs, ANOVA, and multiple regression analyses were conducted to examine the potential factors associated with students' exhibited weight bias.

Findings

Between March 08, 2022, and March 15, 2022, 900 eligible health care students attending 39 Australian universities participated in the study. Students reported varying levels of explicit and implicit weight bias, with minimal differences between disciplines on most outcome measures. Students who identified as men (vs. women) exhibited higher of both explicit and implicit bias (Beliefs About Obese Persons (BAOP): p = 0.0002, Antifat Attitudes Questionnaire (AFA)-Dislike: p = 0.019, AFA Willpower p < 0.0001, Empathy for Obese Patients: p = 0.0011, Implicit Association Test: p = 0.022), and students who displayed greater (vs. less) empathic concern exhibited lower levels of explicit bias (BAOP, AFA Dislike and Willpower, and Empathy for Obese Patients: p < 0.0001). Having witnessed the enactment of weight stigma sporadically (vs. regularly) by role models was associated with greater attribution of the causes of obesity to willpower (a few times a month vs. daily: p = 0.020, a few times a year vs. daily: p = 0.022), and less time spent with people living with overweight or obesity outside of study was associated with more dislike (a few times a month vs. daily: p = 0.0048, once a month vs. daily: p = 0.0002) and less fear of fat (once a month vs. daily: p = 0.036, and once a month vs. a few times a week: p = 0.0028).

Interpretation

Results demonstrate the presence of both explicit and implicit weight bias among Australian health care students. Several characteristics and experiences of students were associated with their weight bias. Validity of the exhibited weight bias should be established in practical interactions with people living with overweight or obesity and novel interventions should be developed to ameliorate weight bias.

Funding

Research Training Program (RTP) Scholarship, Australian Government, Department of Education.

Comparison of two different mindfulness interventions among health care students in Finland: a randomised controlled trial

We investigated the short- and long-term effects of two different evidence-based mindfulness training on students' stress and well-being. A randomised controlled trial with three measurement points (baseline, post-intervention, and 4 months post-intervention) was conducted among undergraduate students of medicine, dentistry, psychology, and logopaedics at the University of Helsinki. The participants were randomly assigned into three groups: (1) face-to-face mindfulness training based on the Mindfulness Skills for Students course (n = 40), (2) a web-based Student Compass program using Mindfulness and Acceptance and Commitment therapy (n = 22), and (3) a control group that received mental health support as usual (n = 40). The primary outcome was psychological distress measured using the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). Secondary outcomes included hair cortisol concentrations and a wide range of well-being indicators. Psychological distress increased in all the groups from baseline to post-intervention, but significantly less so in the intervention groups than in the control group. At 4-month follow-up, were found no differences between the primary outcomes of the control and intervention groups, but the participants who continued practising mindfulness at least twice a week were less stressed than the others. Our results suggest that participating in a mindfulness course may mitigate health care students' psychological distress during the academic year, but only if the participants continue practising mindfulness at least twice a week.

Preceptorship of clinical learning in nursing homes - A qualitative study of influences of an interprofessional team intervention

This study aimed to explore the influences of an interprofessional preceptor-team intervention (IPPT) on interprofessional collaboration, preceptors' role, confidence, and motivation to precept health care students (nursing, physiotherapy) and apprentices in a Norwegian nursing home.

METHODS

Qualitative data were collected by two focus group discussions: possible gains and pitfalls of the IPPT-intervention were focused. The group-discussions were tape-recorded, transcribed verbatim and analysed by means of qualitative content analysis.

FINDINGS

The IPPT-intervention influenced positively on preceptors' confidence and motivation to work as a preceptor and facilitated interprofessional collaboration between the health professionals. The preceptors' role in the ward became clearer and more visible to the peers. Perceived lack of time, a heavy workload, the ward hierarchy, and lack of managerial support were key barriers for preceptorship.

CONCLUSIONS

To enhance preceptors' work and thus student's learning, the ward hierarchy should be limited and interprofessional collaboration further developed. Enhanced visibility and acknowledgement of the preceptors' role and increased managerial support can reduce barriers for preceptorship.

How much can our universities do in the development of cultural intelligence? A cross-sectional study among health care students

BACKGROUND

Cultural intelligence reflects the competence to adapt to new cultural settings. Universities offer students various opportunities to gain cultural learning and develop cultural intelligence. However, there has been little empirical research to compare the effects of cultural learning and other related psycho-social factors in this process.

OBJECTIVE

This study explores the importance of cultural learning and identifies the unique contribution of cultural education in universities to health care students' cultural intelligence.

DESIGN

Cross-sectional survey study.

METHODS

271 health care students completed a survey measuring social desirability, demographics, personality, prior cultural exposure, previous cultural learning and cultural intelligence.

RESULTS

Hierarchical regressions showed that cultural learning could affect cultural intelligence and its three components (i.e., metacognition, cognition, motivation, and behaviour) under the control for related psycho-social factors. However, its effect on the behavioral component was not significant. Considering the different types of cultural learning, overseas study experiences were more related to cultural intelligence, compared to in-class cultural learning.

CONCLUSION

Cultural learning, especially overseas study experiences, plays a significant role in the development of health care students' cultural intelligence.

Exploration of empathy in Cyprus nursing and health care students: A mixed method study

Developing professionals who are perceptive to the needs of patients and can respond by expressing empathetic behavior is one of the aims of health care education. The aim of this study was to explore the level of empathy in health care students through a mixed method. The quantitative approach included the use of the Jefferson Scale of Empathy and the qualitative a focus group approach to further deepen into the descriptive results. 869 health care students (RR=81%) participated in the study and the level of empathy ranged from 42 to 139 with a mean score of 100.6 (20-140 scale). Significant statistical differences were found between the disciplines (F=8.6, p-value<0.001) and gender (p-value<0.001) with nursing students and women scoring the higher levels. Two focus groups of ten participants each were conducted with 3^rd and 4^th year nursing students. Four themes were derived from the analysis of these data a) empathy as an imperative component of care b) contact with the clinical reality c) the influence of family and choice of studies d) gender stereotypes. There is a lack of mixed methodologies in the empathy research and this study provided the opportunity of a better understanding of the health care students' views.

Knowledge, experiences, and attitudes toward Mantoux test among medical and health professional students in Italy: a cross-sectional study

BACKGROUND

The World Health Organization's Action Framework for tuberculosis elimination in low-tuberculosis incidence countries includes the screening for active and latent tuberculosis in selected high-risk groups, including health care workers. In this context, medical and health profession students, exposed to nosocomial tuberculosis transmission during training and clinical rotations, are target populations for tuberculosis screening. No updated data are available on tuberculosis screening practice and knowledge of medical and health profession students in Italy.

METHODS

Within the activities Italian Study Group on Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health, we carried out a multicentre cross-sectional study to assess knowledge, attitude and practices on tuberculosis prevention and control among Medical, Dentistry, Nursing and other health professions' students. Students were enrolled in the study on a voluntary basis and were administered a previously piloted structured questionnaire. Logistic regression models were applied to explore knowledge on tuberculosis prevention by selected socio-demographic variables and University-based tuberculosis prevention practice.

RESULTS

Students of seventeen Universities across Italy participated in the study, and 58.2% of them received compulsory tuberculin skin test either at enrollment or while attending clinical practice. A total of 5,209 students filled the questionnaire. 37.7% were medicine and dentistry students (Group 1), 44.9% were nursing students (Group 2) and 17.4% were other health professions' students (Group 3). Age and gender had different distributions by groups, as well as knowledge and practice on tuberculin skin test. 84.4% of the study population (95% CI = 83.3-85.3) was aware of the existence of the tuberculin skin test, 74.4% (95% CI = 73.2-75.6) knew what is the first-level screening test for latent tuberculosis and only 22.5% (95% CI = 21.4-23.6) knew how to proceed after a positive tuberculin skin test result. Overall, knowledge on tuberculosis prevention was higher in Group 2 and lower Group 3, as compared to Group 1.

CONCLUSION

In Italy, the knowledge on tuberculosis screening among University students is generally good. To reduce some of the criticalities found among the different study courses, it would be appropriate to harmonize both the regulations on tuberculosis screening practices for admission to University courses, and the educational activities on the topic of tuberculosis, to be extended to all workers involved in health care setting.

Adaptation and reliability of the readiness for inter professional learning scale (RIPLS) in the Chinese health care students setting

BACKGROUND

Interprofessional collaboration (IPC) primarily aims to enhance collaborative skills and to improve the awareness of teamwork and collaborative competencies of health care students. The Readiness for Interprofessional Learning Scale (RIPLS) was used to assess such skills. The aim of this study was to adapt a Chinese version of the RIPLS among Chinese health care students and to test the psychometric properties of the modified instrument.

METHODS

The questionnaire was translated following a two-step process, comprising forward and backward translations and a pilot test. The Chinese version was tested on a group of students from various health care professions. Cronbach's α coefficients were calculated for each of the four factors and also for the entire questionnaire in order to evaluate the internal consistency of the Chinese version of the RIPLS.

RESULTS

Of the 295 health care students surveyed, 282 (96.5%) completed the questionnaire. Cronbach's α coefficient for the overall scale was 0.842. Internal consistencies within each factor were good (α > 0.70) except for the factor "Roles and Responsibilities", where α = 0.216. Confirmatory factor analysis showed that the data fit the four-factor structure.

CONCLUSION

The Chinese version of the RIPLS was an acceptable instrument for evaluating the attitudes of the health care students in China. The factor "Roles and Responsibilities" requires further scrutiny and development, at least in the Chinese context.

Interprofessional education and collaborative practice: Psychometric analysis of the Readiness for Interprofessional Learning Scale in undergraduate Serbian healthcare student context

BACKGROUND

There is an implicit expectation for medical sciences students to work together effectively as members of health-care team, and interprofessional education is therefore widely accepted. Students' attitudes, which are affected by various factors, have been recognized as the most important predictors of successful implementation of interprofessional education with the aim of developing collaborative practice. The Readiness for Interprofessional Learning Scale has often been used in studies to measure these perspectives.

OBJECTIVES

To describe the psychometric properties of the Serbian cross-culturally adapted version of the original Readiness for Interprofessional Learning Scale, to assess the attitudes of undergraduate health science students towards interprofessional education and to evaluate whether a professional group and student characteristics have influence on attitudes towards collaborative practice and shared learning.

DESIGN

A descriptive/analytical and comparative cross-sectional study.

SETTINGS

Faculty of Medicine in Serbia.

PARTICIPANTS

Nursing and medical students after completed first clinical rotations (n = 257).

METHODS

The Readiness for Interprofessional Learning Scale for assessing attitudes among students towards interprofessional learning, Professional Identity Questionnaire for Nursing Students for assessing professional identity in nursing students, Professional Nursing Image Survey for assessing attitudes of medical students towards the nursing profession, as well as a socio-demographic questionnaire were the instruments used in this research study. The data were analysed using descriptive and inferential statistics.

RESULTS

Exploratory factor analysis on 19 items revealed two-factors accounting for 51.1% of the total variance with the internal reliability α = 0.90. The mean total score of the Readiness for Interprofessional Learning Scale was 73.5 (SD = 11.5) indicating that students are ready for interprofessional learning. Nursing students, female students; students in their first years of studies, and those with previously completed education in the field of health care, have been more ready for interprofessional learning and collaborative practice. In the multiple linear regression analysis, gender and assessing professional nursing skills and abilities were significant predictors of medical students' readiness for interprofessional learning, whereas professional identity was for nursing students.

CONCLUSION

The Serbian version of the Readiness for Interprofessional Learning Scale has proven to be reliable and valid for the "teamwork, collaboration and shared learning" subscale, while the "role and responsibilities" subscale showed lower stability. The results of this study revealed positive students' attitudes towards interprofessional learning, which is important for Serbia, as a candidate country for European Union membership, and thus making our educational system more inclusive for joining the European Higher Education Area.

Prevalence and correlates of substance use among health care students in Nepal: a cross sectional study

Background

Substance use among health care students threatens professional standards and the delivery of quality services, potentially placing the public at risk. Therefore, our study aims to determine the prevalence and correlates associated with substance use among Nepalese health care students.

Method

A cross-sectional survey using a self-administered health professional questionnaire was conducted among pharmacy, nursing, and public health students at three universities in Nepal in 2010.

Results

We analyzed data from 407 respondents (response rate, 82%) with a mean age of 22 years (standard deviation = 3.71). The overall lifetime prevalence of substance use (i. e., illegal use of prescription drugs and illegal drug use) was 42.8%. Marijuana was the most commonly used illegal drug (8.8%) and minor opiates (e.g., codeine cough syrups) were the most widely used illegal prescription drugs (32.4%). Substance use was directly associated with cigarette smoking, peer influence, and heavy drinking. In addition, respondents reported some major and minor dysfunctions because of their substance use.

Conclusion

The prevalence of substance use among health care students at the three universities in Nepal was high. Peer influence, cigarette smoking, and heavy drinking were significant predictors of substance use.

Electronic supplementary material

The online version of this article (10.1186/s12889-017-4980-6) contains supplementary material, which is available to authorized users.

Implementing professionalism by deprofessionalized strategies: A moral quandary

Monetary fine proceedings has been one of the methods of upholding professionalism amongst health care professionals. Professionalism as a concept is multifaceted and fragmented and it has become symbolic to the extent that, unfortunately, some traits of professionalism showcase the whole concept. It seems fair to interpret the symbolic views on the concept of professionalism as means to capitalize on certain aspects of professions such as commercial profitability for the employer and respected status for the profession. Evaluation of professionalism is often implicit and inadequate; and assessing professionalism by relying on abstract and idealized definitions implies that professionalism is a compounded composite of certain set of stable traits. We suggest to refer to the theory of values-based practice so as to achieve collocated views on professionalism among employers and health academics. Instead of capitalizing on certain traits of professionalism to project the whole concept of professionalism, we may need to relook at the traits of professionalism as values. It is extremely crucial to internalize the values of the health profession in the future health professionals, so that the future health professionals imbibe the professionalism through dialog and democratic methods of sharing values during the course of professional development.

Vaccination coverage among students from a German health care college

Health care students are at risk of acquiring and transmitting vaccine-preventable diseases. The purpose of this study was to assess their vaccination status and the influence of determining factors on their vaccination status. Unsatisfactory vaccination rates (43.8%-94.1%) and significant effects regarding age, sex, and socioeconomic status were found; therefore, there is an increased need for education and motivation for vaccinations in student training.

Health care students' personal experiences and coping with bullying in clinical training

Previous studies show that health care students have experienced bullying by nursing staff in clinical training. Although these studies provide plenty of information considering the manifestation and consequences of bullying on students, there is a gap of knowledge on how health care students' cope with bullying. In addition, previous studies seem to have focused only on the experiences of nursing and midwifery students. This paper presents the results of a qualitative study exploring the bullying experiences of Finnish health care students (n=41) representing two Universities of Applied Sciences. In order to provide information for faculties of health care on bullying intervention and prevention strategies, this study aimed at describing health care students' experiences and coping with bullying in clinical training. Based on previous study findings, an electronic semi-structured questionnaire was developed for the data collection. The qualitative data was analysed using inductive content analysis. The results show that the students experienced verbal and non-verbal bullying in clinical training. In addition to psychological and physical symptoms, bullying also decreased the students' learning, their studying motivation and their professional engagement. One reason why some students did not share their bullying experiences with their teachers and clinical instructors was their idea that sharing their experiences would be useless. On the other hand, students who did share their experiences with a teacher or a clinical instructor usually received emotional support, information, and help in the form of bullying intervention. The results of this study suggest that faculties of health care need to develop action plans against bullying in co-operation with clinical training sites in order to ensure students' learning and professional engagement. In the future, it is suggested that research is focused on factors preventing and contributing to bullying towards health care students.

Influenza immunization practices and policies for health care students in Canada

BACKGROUND

Influenza vaccine is recommended for all health care providers including health care students. Little is known about how health care student programs provide information about influenza vaccination to their students, deliver vaccines and document their vaccination status.

METHODS

A mixed-methods approach was used and included key informant interviews of program coordinators for health care student programs in Halifax (Nova Scotia) and a national survey of program coordinators of health care student programs across Canada.

RESULTS

All 21 coordinators of programs that had students placed at the IWK Health Centre (Halifax, Nova Scotia) during the influenza season were interviewed. Surveys were completed by 93 (36.3%) of 256 eligible coordinators representing 134 different programs (response rate 52.3%). Most programs encouraged seasonal influenza vaccination but only 28 (20.9%) required it. None of the Halifax programs delivered influenza vaccine and most preferred a coordinated, centrally administered program. In contrast, many programs across Canada delivered influenza vaccine and did not desire a centralized process.

CONCLUSION

There is considerable variability in the delivery of influenza vaccine to health care students across Canada. Coordinated programs may be desirable where delivery programs do not already exist.