Virtual-reality-enhanced mannequin to train emergency physicians to examine dizzy patients using the HINTS method

Guillaume Ursat; Morgane Corda; Julien Ryard; Christophe Guillet; Caroline Guigou; Cindy Tissier; Alexis Bozorg Grayeli

doi:10.3389/fneur.2023.1335121

Virtual-reality-enhanced mannequin to train emergency physicians to examine dizzy patients using the HINTS method

Front Neurol. 2024 Jan 5:14:1335121. doi: 10.3389/fneur.2023.1335121. eCollection 2023.

Authors

Guillaume Ursat¹, Morgane Corda², Julien Ryard³, Christophe Guillet³, Caroline Guigou^{2

4}, Cindy Tissier¹, Alexis Bozorg Grayeli^{2

4}

Affiliations

¹ Emergency Department, Dijon University Hospital, Dijon, France.
² Otolaryngology Department, Dijon University Hospital, Dijon, France.
³ Institut Image, Ecole Nationale d'Arts-et-Métiers, Chalon-sur-Saône, France.
⁴ ICMUB, CNRS, Université Bourgogne-Franche-Comté, Dijon, France.

Abstract

Introduction: Acute vertigo is a frequent chief complaint in the emergency departments, and its efficient management requires thorough training. The HINTS protocol is a valid method to screen patients in the emergency room, but its application in routine is hindered by the lack of training. This study aimed to evaluate the training of emergency physicians for the HINTS method based on a mannequin-based virtual reality simulator (MBVRS).

Methods: We conducted a monocenter, prospective, longitudinal, and randomized cohort study in an Emergency Department at a regional university hospital. We included 34 emergency physicians randomized into two equal groups matched by age and professional experience. The control group attended a theoretical lesson with video demonstrations and the test group received a simulation-based training in addition to the lecture.

Results: We showed that the test group had a higher diagnosis performance for the HINTS method compared to the control group as evaluated by the simulator at 1 month (89% sensitivity versus 45, and 100% specificity versus 86% respectively, p < 001, Fisher's exact test). Evaluation at 6 months showed a similar advantage to the test group.

Discussion: The MBVRS is a useful pedagogic tool for the HINTS protocol in the emergency department. The advantage of a unique training session can be measured up to 6 months after the lesson.

Keywords: HINTS; acute vestibular syndrome; head-impulse test; simulation; training; vertigo; virtual reality.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by Amplifon, Audika et Société ORL de Bourgogne.