The use of virtual reality (VR) in medicine is rapidly expanding, particularly in areas like pain management, surgical training, and mental health therapy. This study examines the implementation and effects of the Cold River VR application, a fully immersive tool designed to help manage pain and anxiety during dressing changes for burn trauma patients in a Czech hospital. The Cold River application immerses patients in a peaceful, interactive virtual environment, utilizing eye-tracking technology to engage them without the need for physical controllers, which could interfere with wound care. The study included 67 participants and found that Cold River effectively distracted patients, making the often painful and anxiety-provoking dressing changes more bearable. While stakeholder interviews indicated that the VR application was generally well-received and seen as a valuable tool in reducing patient discomfort, challenges such as lengthy calibration and occasional issues with nausea and headset discomfort were noted. Importantly, the Cold River application increased patient engagement and reduced the psychological burden associated with burn care, though it also highlighted the need for customization based on individual patient preferences and conditions. Overall, the experience with Cold River suggests that immersive VR holds significant potential for improving patient care during burn treatment, particularly when tailored to specific patient needs and contexts.
- Klíčová slova
- Cold River,
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- management bolesti metody MeSH
- mladý dospělý MeSH
- pacienti psychologie MeSH
- popálení * ošetřování psychologie terapie MeSH
- postoj zdravotnického personálu MeSH
- senioři MeSH
- terapie pomocí virtuální reality * metody přístrojové vybavení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: Studies from different countries report a stagnation or regression of moral competence in medical students between the first and the last year of their studies, and the value of various educational interventions remains uncertain. METHODS: We used Moral Competence Test (MCT) to measure C-scores of moral competence to determine the change in the MCT C-scores between the first- and the fifth-year medical students from two medical schools in the Czech Republic in the academic year 2022/2023 and to analyze factors associated with the C-scores (observational study). In addition, for the first-year students, we compared the results of the MCT before and after an intervention in medical ethics curriculum (interventional study). We used a cross-sectional and descriptive design for the observational study. Students completed the MCT, consisting of two moral dilemmas (Worker ́s Dilemma and Doctor ́s Dilemma), the results measured by the C-score, which represents moral competence. RESULTS: In total, 685 students participated in the observational study. Objective 1: based on the analysis of the C-score, we observed a decrease in moral competence between the first and the fifth-year medical students (p < .001). Objective 2: we did not observe a statistically significant effect of gender (p = .278), or self-rated religiosity (p = .163). Objective 3: in the interventional study, 440 students participated in the pretest and 422 students participated in the posttest. The test of statistical significance found no improvement in students' moral competence after the intervention (p = .253). CONCLUSION: Medical students show a regression in moral competence during medical education; it was lower in medical students in their fifth year, compared to the first-year medical students without the effect of gender, or self-rated religiosity. Although educational intervention consisting of multiple tools of medical ethics teaching (PBL, CBL, KMDD and StorED) did not lead to increase in moral competence, the longitudinal effect of such intervention remains to be seen.
- MeSH
- dospělí MeSH
- kurikulum * MeSH
- lékařská etika * výchova MeSH
- lidé MeSH
- mladý dospělý MeSH
- mravy * MeSH
- průřezové studie MeSH
- studenti lékařství * psychologie MeSH
- studium lékařství pregraduální metody MeSH
- vyprávění MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- Česká republika MeSH
Virtuální realita se používá při léčbě celé řady psychických zdravotních obtíží. Není však jen dalším technologickým stupněm využívání her v terapeutickém procesu, ale přináší sebou i řadu nových psychických fenoménů (např. prezenci včetně embodimentu), které proměňují povahu zážitku ze hry. Na druhou stranu je míra zakoušené prezence závislá na určitém stupni technologické úrovně, jejíž dosavadní vrchol představuje tzv. vysoce imerzivní virtuální realita ( fully immersive virtual reality ). Jednou z možností, jak virtuální realitu při léčbě psychických obtíží využívat, je pomocí přímých nebo nepřímých terapeutických her. Existuje již velké množství terapeutických her také v různých stupních virtuální reality směrem k vysoce imerzivní virtuální realitě. Cílem tohoto článku je představit využívání a vytváření terapeutických her ve virtuální realitě a dalším cílem je představit model složený ze tří komponent – hráč, hra a terapie – autorů Mader et al. (2012) pro tvorbu terapeutických her ve virtuální realitě na příkladu vývoje aplikace pro snižování procedurální bolesti u pacientů s popáleninami a na příkladu naší vlastní aplikace Cold river.
Virtual reality is used to treat a variety of mental health problems. However, it is not only another technological stage in the use of games in the therapeutic process, but it also brings with it a number of new psychic phenomena (e.g. presence, including embodiment), which change the nature of the game experience. On the other hand, the degree of experienced presence depends on a certain level of technological level, the current peak of which is the so-called fully immersive virtual reality. One of the ways to use virtual reality in the treatment of mental disorders is through direct or indirect therapeutic games. There are already many therapeutic games also in various degrees of virtual reality towards fully immersive virtual reality. The aim of this article is to present the use and creation of therapeutic games in virtual reality and another aim is to present a model composed of three components – player, game and therapy by Mader et al. (2012) for the creation of therapeutic games in virtual reality on the example of the development of an application for reducing procedural pain in patients with burns on the example of our own application Cold river.
