Effective communication is critical to all teams, but more so in environments where teamwork has direct implications on the outcome. Specifically, in healthcare, critical communication is crucial for patient safety. Healthcare incidents documented through well known cases have shown that many medical errors are contributed to bad interpersonal communication in teams. In addition to patient safety, failure in communication between healthcare team members can have implications on patient compliance. Good team communication can lead to positive outcomes for patients.
Healthcare teams encounter the same issues that other teams may encounter- different personalities, conflicts, lack of leadership and organisational hierarchies. However, within healthcare, the focus of staff education and training is largely on improvement of technical skills. At Torbay and South Devon NHS Foundation Trust, human factors skills (non-technical) are also seen as critical to optimum functioning and delivery of healthcare services. As part of the human factors’ skills programme, we run simulation workshops to teach non-technical skills like effective communication, patient perspective, and empathy. These workshops are presented using a combination of immersive technology tools paired with face-to-face debriefing by clinicians.
For the past two years, our VR Lab has been using a novel approach to incorporate fun and games in learning. Gamification, which is the use and integration of gaming in non-gaming, education contexts, can be achieved through VR headsets. Gamified educational experiences can immerse the users and, encourage them to reflect on their behaviours and actions. Although gamified VR has been used to teach technical skills of gynaecology, laparoscopy, and arthroscopy, it has not been incorporated in non-technical skills education. At Torbay Immersive Lab, we run workshops titled ‘VR Team Talk’ during break sessions. These workshops are based on the use of the VR bomb defusal game- ‘Keep Talking and Nobody Explodes’. Teams of 4 or 5 are invited to participate in this fun educational experience, wherein one person is nominated to wear the VR headset and remaining players get a written manual for bomb defusal. The goal is to communicate with one another and defuse the bomb within 5 minutes. The game brings everyone to the edge as it carries an element of time-pressure and stress. Team players need to describe the bomb defusal instructions in best possible manner so that the player using the VR headset can follow through. In addition, the player in VR must describe the virtual scenario which rest of the team is unable to view. The teams who participate are often multidisciplinary with varied seniority, and often have no previous experience of working together. Upon completion of the game, the clinical lead debriefs the session using the observational notes made during the gameplay. Similarities between the game situation and actual clinical situations are drawn to help players in reflecting on their communication skills within the team.
Most players are unaware of how their individual communication and team communication had implications on the outcome of the game. Time pressure experienced within the game is very real as it simulates the chaotic stress filled nature of real ICU environments. Such stress leads to communication errors. Very few teams can defuse the bomb successfully, which highlights the importance of effective communication. On the other hand, often times the team players who come across quiet or shy at the start of the workshop, speak up more during the game and may end up taking the lead. No two teams are similar. The events that occur within the 5 minutes of the game provide many discussion points for reflection on communication and behavioural errors.
Our experience of running the novel ‘VR Team Talk’ workshops has been positive. Attendees love and engage well with the game. Feedback from the workshops has been positive and gamified VR is accepted as a suitable intervention for teaching effective team communication skills. As part of service-quality evaluation, we have been able to gain feedback on the suitability and acceptability of the intervention. Next step is to run a longitudinal study to assess the real-life implications of ‘VR Team Talk’ on workshop attendees’ behaviours within clinical settings over a period of 6 months. Due to COVID-19 pandemic we are currently unable to run the workshops.
If you are interested in running similar workshop, we recommend the following-
- One untethered VR headset like the Oculus Go or Oculus Quest
- Keep Talking and Nobody Explodes game
Duration for a single workshop is between 30-45 minutes. One person is required to hygienically clean and set up the game on the VR headset and be available on standby to assist with any technical problems. Clinical lead is required to explain the task, observe, and debrief at the end. If you would like to learn more about debriefing, please get in touch with us.
You can purchase and download the Keep Talking and Nobody Explodes game here
Some good reads on communication and its role in patient safety and healthcare outcomes:
Author: Payal Ghatnekar