Development of a Standardized Evaluation Model for Virtual Reality-Based Emergency Training: A Delphi Study on Competency Criteria for Interprofessional Teams

Jana Adams¹Martina Weidler²Jorge Pereira Santos²Sarah Hermanns²Sven Dannemann²Jens Möllenbeck²Pascal Wegmann²Lukas Schatzl²Rebecca Schatzl²Patrick Dehn²Niels Adams³Hendrik Drinhaus³David Sander³Cornelia zur Nieden³Tobias Kammerer³Hannes Ecker³Robert Schier⁴Robert Kleinert⁵Christiane Bruns⁶Rabi R. Datta^6*

• ¹Medical Faculty and University Hospital Cologne, Department of Obstetrics & Department of Gynecology, University of Cologne, Cologne, Germany
• ²University Hospital of Cologne, Department of Nursing and Generalist Nursing Education, University of Cologne, Cologne, Germany
• ³Medical Faculty and University Hospital of Cologne, Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany
• ⁴University of Marburg, Medical Faculty and University Hospital of Fulda, Department of Anesthesiology and Intensive Care Medicine,, University of Marburg, Fulda, Germany
• ⁵Medical Faculty and University Hospital of Bielefeld, Department of Surgery, University of Bielefeld, Bielefeld, Germany
• ⁶Medical Faculty and University Hospital of Cologne, Department of General-, Visceral-, Thoracic- and Transplant Surgery, University of Cologne, Cologne, Germany

Background: Effective collaboration among healthcare professionals is essential for delivering high-quality patient care, especially in emergencies. As healthcare education adopts new technologies, virtual reality (VR) is gaining traction for enhancing emergency response skills. To define key learning objectives and best practices for a newly developed VR-based emergency training program in surgical wards, an interprofessional modified Delphi study was conducted. Methods: A five-round modified Delphi method was conducted with 17 participants from medical and nursing backgrounds. Round 1 involved an interprofessional discussion to identify critical actions, common errors, and preliminary learning goals. In Round 2, participants interacted with the VR simulation and refined the objectives in a follow-up discussion. In Round 3, 157 statements were rated using a five-point Likert scale. Items lacking consensus (<80% agreement, IQR >1, or median ≤4; n = 76) were discussed again in Round 4. Revised items were anonymously re-evaluated in Round 5. Results: The Delphi process resulted in consensus on 131 of 157 items (84%), defining a structured framework of core interprofessional competencies, including key learning objectives, essential clinical actions, teamwork principles, and time-critical decision points for VR-based emergency training. No consensus was reached for 26 items (16%). Between Rounds 3 and 5, eight items showed differing ratings between physicians and nurses, which were reduced to four after interprofessional discussion. Conclusion: This study resulted in a consensus-based framework of interprofessional learning objectives and key competencies for VR-based emergency training. It highlights the value of structured interprofessional collaboration in the systematic development of evaluation-oriented educational frameworks for ward-based surgical emergencies.