Background: Significant variability in stroke management exists, in part due to workflow complexity and requirements for effective coordination across multi-disciplinary teams. We hypothesised that new workflow training using virtual reality could reduce process variability and improve patient outcomes.
Aims: We developed TACTICS VR, a portable training application to upskill healthcare staff in best-practice stroke workflow. Trainees work through a real-world case, making active decisions and receiving real-time feedback. We assessed the usability, acceptability, utility and feasibility of multiple TACTICS VR modules in real-world clinical contexts specifically targeting 1) doctors, 2) telestroke, 3) nurses and 4) paramedics.
Methods: Four modules for TACTICS VR have been developed in partnership with multiple local health districts, including the Agency for Clinical Innovation and NSW Ambulance. The first focused on Hyper-acute Stroke Management and created as part of a package intervention within the TACTICS implementation trial (Ryan et al. 2022 BMJ Open). A Telestroke module supported the state-wide roll-out of NSW Telestroke Service. The third module supports in-hospital stroke nursing and the most recent module supports pre-hospital paramedic training in relation to stroke care processes.
Results: TACTICS VR has now been used in 50+ hospitals in NSW, QLD and SA, including >700 sessions totalling >240 training hours. Trainee feedback indicates high levels of usability, acceptability and utility in multiple clinical contexts. Specifically, after completing TACTICS VR trainees report increased confidence to make improvements in stroke management and confidence in understanding stroke workflow practices and believe VR is effective to teach / transfer knowledge for acute stroke.
Conclusion: TACTICS VR is a fit-for-purpose, evidence-based training application for stroke workflow optimisation that can be readily deployed in a clinical setting. We continue to explore approaches to sustain training and expand modules both within stroke and in other hyper-acute clinical contexts.