Improved Management of Nephrological Emergencies through Immersive Technology

Background: Medical emergencies require rapid initial assessment and immediate action. Many medical students and young physicians often feel overwhelmed in such situations and report inadequate preparation for real-world emergencies. Immersive technologies, such as Virtual Reality (VR), offer new opportunities for realistic simulation training with significant potential in practice-based medical education, including emergency management. To investigate its effectiveness in the field of nephrology, we selected rapidly progressive glomerulonephritis (RPGN) as a well-known prototypical nephrological emergency, which requires swift action to avert life-threatening complications. Methods: Using an innovative approach, we conducted a single-center study employing a self-designed, 3D virtual, interactive RPGN case represented by an avatar patient on the VR simulation platform STEP-VR, which we recently developed and validated in partnership with ThreeDee. We compared the competencies of third-year medical students before and after VR training with those of a control group. Additionally, we evaluated the impact of synchronous tutorial support during the training on learning outcomes. Results: A total of 275 medical students participated in the study, with an average age of 25.4 years; 64% of the participants identified as female (n=176). The VR training group showed significantly improved outcomes in the diagnosis of RPGN, based on clinical presentation, laboratory diagnostics, urine dipstick, and urine sediment analysis (p<0.0001 for all comparisons). The VR group also significantly outperformed the control group in managing RPGN-associated complications, such as severe hyperkalemia and metabolic acidosis (p < 0.0001). Additional guidance by a human tutor led to further improvements in diagnosis and treatment performance. Conclusion: Our findings highlight the potential of immersive technology as an effective medium for enhancing clinical nephrological knowledge and skills. Specifically, the use of realistic and practice-oriented VR simulation training in medical education and training could lead to improved competence in handling nephrological emergencies and, consequently, enhance the quality of patient care. Taken together, VR may be an effective, cost-efficient, and scalable alternative to traditional simulation methods.