A Pilot Non-Inferiority Study of Effectiveness of Face-to-Face Versus Virtual Reality on Undergraduate Physiotherapy Students’ Confidence and Self-Efficacy With Tracheostomy Skills

Introduction: The number of tracheostomies performed annually in resource-rich countries is estimated at 250 000. Without adequate training, staff caring for patients with tracheostomies can feel underprepared, lacking both competence and confidence. Training is essential to support both patients and health care staff but is often sporadic and nonstandardized and rarely includes those at preregistration level. The purpose of this study was to explore the potential for delivering a newly developed virtual reality (VR)-based tracheostomy education with traditional face-to-face teaching to undergraduate physiotherapy students. Methods: A pilot non-inferiority study with randomization of interventions comparing traditional face-to-face teaching with a VR-based tracheostomy education program. The content of both training approaches was standardized and based on local existing education content. The primary outcome was changes in knowledge, confidence, and self-efficacy. Results: Thirty-nine undergraduate physiotherapy students were recruited, with 18 (47.4%) receiving tracheostomy training via VR. All participants demonstrated significant improvements in knowledge, confidence, and self-efficacy when comparing pre- and posttraining. A greater change was observed in those receiving VR-based training although not statistically significant. Additional results showed a reduction in facilitator activity during the VR sessions but a requirement for technical support. Conclusions: VR-based tracheostomy training is equivocal to face-to-face training for increasing undergraduate students’ knowledge, self-efficacy, and confidence. There may be additional benefits of VR-based training including reduced facilitator training time, but these need to be further assessed considering the technical support required for immersive technology.