Utilization of Virtual-Reality in Establishing a Code Trauma Crisis Resource Management Training Module

Riyadh Firdaus,1,2 Aida Rosita Tantri,1 Sidharta Kusuma Manggala,1,2 Anggara Gilang Dwiputra,1 Bintang Pramodana,1 Aino Nindya Auerkari,1,2 Noor Hafidz,1 Andy Omega,1 Dewi Larasati1 1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 2Rapid Response Team, Dr. Cipto Mangunkusumo Hospital, Jakarta, IndonesiaCorrespondence: Riyadh Firdaus, Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, Tel +62 21 3143736, Email riyadh.firdaus@ui.ac.idPurpose: Crisis Resource Management (CRM) is critical in managing code trauma cases, yet remains underemphasized in many medical training programs in Indonesia. This study aimed to develop and evaluate a virtual reality (VR)-based CRM training module tailored for emergency physicians.Patients and Methods: A pilot CRM module was designed through expert focused group discussions (FGDs) and refined using the Delphi method. The module included a lecture, roundtable discussion, and VR simulation. Fifteen emergency physicians participated in the training and were assessed using pre- and post-tests, a checklist based on CRM objectives, the Ottawa General Rating Scale (GRS), and a satisfaction questionnaire.Results: Participants showed a significant improvement in knowledge (mean pretest 70 vs posttest 95.33; p < 0.001). Checklist completion rates had a median of 81% individually and 80% at the team level. Ottawa GRS scores indicated strong performance in leadership, problem-solving, communication, and situational awareness (overall mean score: 6.2/7). Satisfaction ratings reflected positive participant experiences with the module.Conclusion: VR-based simulation is an effective, accessible tool for enhancing CRM skills in emergency settings, particularly in low-resource or remote environments. The module demonstrated high participant satisfaction and notable improvements in both individual and team performance and incorporating VR into trauma team CRM training should be considered.Keywords: clinical competence, continuing medical education, emergency medicine, focus groups, healthcare team, virtual reality, focused group discussion, Ottawa GRS scores, crisis resource management