Behavioral Assessment in Virtual Reality: An Evaluation of Multi-User Simulations in Healthcare Education

ABSTRACT Human error in medicine – medical error – has been identified as the third leading cause of death within the United States. Analyses of deaths attributable to medical error conclude that faulty communication plays a central role in medical error. Patient handoffs, the transfer of patient care from one medical professional to another, are frequently occurring behavioral events in healthcare settings where communication accuracy is vital. The medical industry looks to lessons learned from other highly technical, risk-inherent industries such as aviation; they have created a training package called TeamSTEPPS® to address medical error. Among such initiatives, a fundamental challenge is the objective measurement of specific, critical skills. Behavior science offers a robust history of objective behavioral measurement and assessment, and virtual reality (VR) provides a measurement-rich platform for assessing behavior in simulations. The replacement of in-person (Direct) simulations with VR lacks validation research. The present study evaluated the validity of using VR simulations in healthcare education to measure and assess critical skills identified by the TeamSTEPPS® framework for healthcare professionals during simulated patient handoffs.