A pilot study to compare virtual reality to hybrid simulation for opioid-related overdose and naloxone training

Background: In the midst of the international opioid-related overdose (OOD) crisis, appropriate naloxone training is needed by both healthcare professionals and community members to better leverage its life-saving potential. Objective: Pilot the use of a virtual reality simulation for training student nurses to identify signs and symptoms of an OOD, properly administer intranasal naloxone, and provide immediate recovery care after revival. Design: This quasi-experimental pretest-posttest study evaluated knowledge and attitudes towards intervening during an opioid-related overdose among student nurses before and after participating in a traditional hybrid simulation or virtual reality simulation. Setting: A medium sized urban university's school of nursing in the Northeastern United States. Participants: Fifty (N = 50) senior Bachelor of Nursing Science (BSN) students. Methods: Knowledge and attitudes were assessed using the Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitudes Scale (OOAS). Students completed measures 3 weeks prior to training and 3 weeks after. Appropriate t-tests evaluated changes in OOAS and OOKS scores both within and between training groups (e.g. hybrid simulation compared to virtual reality). Results: Sample characteristics were well balanced in both the hybrid simulation group (n = 31) and virtual reality group (n = 19). There were no statistically significant differences in average OOKS and OOAS scores at baseline or at follow up between those receiving hybrid simulation or the virtual reality training. All participants' attitudes scores decreased from baseline to follow up by <2 points. However, there was no difference in the change in knowledge scores between the training groups. Conclusions: Individuals participating in the virtual reality simulation had similar knowledge retention and attitudes towards responding during an opioid-related overdose and administering intranasal naloxone when compared to individuals participating in hybrid simulation. The lack of significant findings between training groups indicates that the mobile virtual reality training is comparable to the in-person hybrid simulation for training nursing students to appropriately administer naloxone to reverse OOD and provide immediate recovery care after revival.