The Virtual Resus Room (VRR) is a free, open access healthcare simulation modality to run clinical simulation online. This is an incredible free resource for the global healthcare simulation community to be able to deliver high quality virtual simulations at no cost and to a high standard. VRR is used across the world in a number of different countries and includes both high and lower resource environments. This article by Erin Carn-Bennett, RN, MSN will explore VRR, how this online platform works and what resources are available on their website in order to get started.
The Story Behind the Creation of VRR
VRR was created in May 2020 by Dr. Sarah Foohey from Canada. Sarah had experienced the power of healthcare simulation in her fellowship year. However, when the Covid19 pandemic stopped clinical simulation education for the University of Toronto CCFP-EM residents, Sarah searched online for a free, easy-to-use virtual clinical simulation alternative that could replace valuable in situ healthcare simulation scenarios. When Sarah was not able to find any virtual healthcare simulation options that suited online, she created her own in the form of Virtual Resus Room.
VRR is used across the world in a number of different countries and includes both high and lower resource environments. VRR has won a number of prestigious awards and also been presented at a number of conferences. Some of VRR’s awards include: Canadian Association of Emergency Physicians Innovation Abstract Competition Winner 2021, Society of Academic Emergency Medicine FOAM showcase second place 2021, University of Toronto Excellence in Development and Use of Innovative Instructional Materials 2021, CORD, ACEP, Urgent Matters Emergency Medicine Innovator of the Year 2021. VRR is used in distributed remote learning for: Pedistars India, PECC-Kenya and INDUS University of Healthcare Sciences.
Since VRR’s inception in 2020, VRR has been used by clinical educators across the globe to deliver high quality online virtual simulation courses. VRR is an open-access and free project with an extraordinary amount of resources available to support VRR course delivery on their website. VRR was started on the simple belief that online healthcare simulation should be accessible, high yield, and fun. VRR started out as an informal project for seven residents in Toronto. VRR was developed with the assistance of a group of educators who helped as peer reviewers, early adopters, and champions.
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Early stage development input for VRR was from: Dr. Paul Koblic, Dr. Teresa Chan, Dr. Alim Nagji, Dr. Virginia Brown, Dr. Allison Yantzi, Dr. Chelsea Hall, Dr. Alex Alferis, Dr. Zainab Najarali. VRR pediatric simulation champions of VRR are: Dr. James Leung, Dr. Jabeen Fayyaz, Dr. Marc Auerbach, Dr. Dennis Ren, Dr. Pavan Zaveri, Dr. Sam Zhao, Dr. Brian Lee. Other key supporters of VRR have been: EMSimCases, EMCases, and Simulation Canada who provided a platform to share the VRR in the early months of inception.
Google Slides and Zoom Form VRR Experiences
The VRR “room” is built in google slides and VRR learners are able to open up pre-built google slide rooms on their laptop or computer. Learners are able to watch, click, drag, copy/paste, and type notes within the google slide room which creates live edits to resus tasks as they are completed. The use of Zoom (or a similar audio-visual conference tool) means that VRR participants can see and communicate with each other as a team in real time in a virtual simulation. On the VRR website there is access to use more than fifty prebuilt “Ready to Run Cases” or there is the option to build cases from scratch as well. Ready to run VRR cases include: adults. pediatrics, beyond the ER and in French language.
Course Preparation is Key to a Successful VRR Course
There is pre-course work required to be able to effectively run a VRR course online. VRR participants need to be introduced and orientated to VRR. Commonly at first some participants will feel overwhelmed with the concept of how the technology works. A link to instructions and resources should be shared with learners ahead of time. VRR sessions should be commenced with a pre-brief and orientation to ensure that participants know how to: open the slide deck, click and drag, copy & paste and other functions.
One of the learner challenges is how to see zoom and google slides at the same time. For first time VRR users be sure to explain how to resize browser/app windows in detail to set learners up for success. Ensure that there has been enough pre planned orientation, training and plan time for the faculty as well. A course plan and scenario sheets are helpful as well for faculty as well as clear faculty roles. Examples of these may include: scenario director, scenario technician to alter observations and debriefers.
VRR Supplies a Number of Valuable Resources for Facilitators
The VRR website is incredibly comprehensive and has extensive amounts of useful information and resources. There are a number of suggestions which can assist to run the first VRR course with useful details to set up VRR course planning for success. Recommended small group sizes are 4-6 Learners. VRR sessions run best if everyone in each breakout room has an active role and there are no observers. There is the capability with enough faculty to run multiple groups in parallel at the same time in simultaneous breakout rooms. Allow one hour for each case ideally, this is broken down into twenty minutes for the scenario followed by a thirty minute debrief and ten minute break.
VRR ideally should be used on a laptop in a quiet space with good quality Wifi access. The use of tablets is a possibility but some google slides features are a bit more difficult to use on tablets and phones. A quiet environment ensures more ease for the VRR team to communicate in the virtual simulation scenario. There are a huge number of incredibly detailed resources available on the VRR website such as how to design a VRR room step by step as well as delivery tips and tricks to ensure a successful virtual resus room virtual simulation course.
Virtual Resus Room allows participants to divide into normal team roles to care for the virtual simulated patient. The VRR team should aim to utilize communication skills such as: use of names, clear delegation of tasks and closed loop communication. Facilitators provide VRR participants information about the virtual simulation patient and answer any questions as well as provide prompts as the clinical case progresses.
At the commencement of a VRR course the facilitator will let participants know at the start of the course that a little imagination will be required. The purpose of VRR is not to pretend that the process to click and drag pictures around google slides simulates the real life clinical practice complexity. However, VRR is an effective virtual simulation tool for mental rehearsal, generation of important debrief conversations, and the rehearsal of key communication and team work skills. Virtual Resus Room has also expanded to include “Tabletop Resus Room” which is a free open access tabletop simulation resource.
Virtual Resus Room is a valuable, free, open access virtual simulation platform and learner guide. VRR has been developed by leaders in healthcare simulation within both adult and pediatric medicine in Canada. VRR has expanded greatly across the world into many clinical simulation programs successfully for both low and high resource environments. Virtual Resus Room is an incredible virtual simulation resource which has a raft of useability in many environments.
