Abstract
KEY POINTS: Virtual reality simulation provides a realistic training solution for medical emergencies. For the first time, we present the development of a virtual reality emergency simulation specifically for nephrology. Immersive virtual reality training may be an effective, cost-efficient tool for improving nephrology knowledge, skills, and patient care. BACKGROUND: Medical emergencies require rapid assessment and prompt intervention. However, many medical students and early-career physicians often feel overwhelmed in these high-stakes situations, reporting limited exposure and inadequate preparation for real-life emergencies. Immersive technologies, such as virtual reality (VR), offer new avenues for realistic simulation. Recognizing the lack of comprehensive nephrologic emergency simulations, we sought to address this gap by designing a case focused on rapidly progressive GN (RPGN)—a prototypical nephrologic emergency requiring urgent treatment to prevent life-threatening complications. Here, we outline the conceptualization, step-by-step development, implementation, and assessment of learning outcomes. METHODS: We developed and evaluated a de novo VR-training module focusing on AKI and hyperkalemia secondary to ANCA-associated vasculitis induced RPGN. The scenario features an interactive avatar patient and incorporates both standard clinical procedures and specialized nephrologic examinations. After initial development, we conducted a single-center pilot study with fifth-year medical students to assess its educational value and improve the prototype. The evaluation combined quantitative and qualitative feedback questionnaires, while learning success was assessed using a preintervention and postintervention knowledge test. RESULTS: The study cohort comprised a total of 201 medical students with a mean age of 25.4 years (SD ±2.9). Analysis of student performance revealed variability in recognizing clinical findings. After history-taking, a noticeable shift in diagnostic reasoning emerged: the proportion of kidney-related differential diagnoses was higher, while that of cardiac-related diagnoses was lower accordingly. Furthermore, VR-based intervention resulted in a substantially higher participants' knowledge, evidenced by a 136% increase in mean test scores and a large effect size (Cohen d=2.22). CONCLUSIONS: We designed a VR scenario for evaluation of a patient who presents with AKI and hyperkalemia secondary to RPGN. Using this approach, trainees developed higher competence. This immersive technology provides an effective and cost-efficient tool for advancing clinical nephrology knowledge, skills, and engagement.