Transforming the Heart of Student Learning and Engagement

Purpose: Entry-level physical therapists must effectively learn cardiovascular and physiological monitoring, including electrocardiography (ECG) interpretation, to fulfill the demands of acute care hospital settings. Preliminary evidence among medical students and young physicians suggests that proficiency in basic ECG interpretation may be insufficient to meet the needs of a society with increasing levels of cardiovascular disease. In addition, as a new generation of students (Generation Z) enters health care education programs, educators may need to adapt their instructional approaches and technology. The purpose of this study was to evaluate whether a novel virtual reality (VR) learning module resulted in more accurate ECG interpretation than a conventional written learning activity for predominantly Generation Z Doctor of Physical Therapy (DPT) students. The study also assessed whether a preference existed for either of the 2 activities. Methods: A blocked-randomized controlled crossover trial was integrated within a second-year cardiopulmonary course for DPT students. Students were blocked into 2 groups, VR-Conventional or Conventional-VR, based on the order in which they participated in the activities. Twenty-item multiple-choice knowledge assessments and a satisfaction survey were the outcomes. Results: Eighteen DPT students participated. Median pretest scores for the VR-Conventional group and the Conventional-VR group were 60% (interquartile range [IQR]: 50-75) and 65% (IQR: 55-75), respectively; the distributions were not different (Mann-Whitney U test =36.00, n1 = n2 = 9, P = .688, 2-tailed). Median posttest 1 scores for the VR-Conventional group and the Conventional-VR group were 70% (IQR: 62.50-85) and 75% (IQR: 67.50-85), respectively; the distributions were not different (Mann-Whitney U test = 39.00, n1 = n2 = 9, P = .893, 2-tailed). After crossing over, the VR-Conventional group scored 70% (IQR: 62.50-80) on posttest 2 while the Conventional-VR group scored 70% (IQR: 65-77.50); the distributions were not different (Mann-Whitney U test = 38.50, n1 = n2 = 9, P = .858, 2-tailed). Fifty percent of participants preferred the VR activity, 33% preferred the conventional written activity, and 17% had no preference. All participants reported wanting to see VR used more in education. Conclusions: VR was well received and may aid student engagement and motivation for learning complex topics such as ECG interpretation. In this study, VR was not superior to conventional learning activities for knowledge acquisition. Educators should additionally consider an evidence-based instructional design when choosing to integrate VR technologies in the classroom.