Use of Virtual Reality to Educate Undergraduate Medical Students on Cardiac Peripheral and Collateral Circulation

An exploratory study to compare the effects of immersive virtual reality based training on the learning motivation of final year medical students as compared to video and text-based learning. Different modes of delivery of a training simulation of laparoscopy operation were presented to students and learning motivation corresponding to which were evaluated using the Intrinsic Motivation Inventory. The study was conducted from September 2018 to May 2019. Undergraduate medical students from 8 medical colleges and universities across Punjab, Pakistan participated in this study. A total of 87 students with a mean age of 22.5 ± 4 years were recruited for the study. Of these, 57.4% (n = 50) were males and 42.6% (n = 37) were females. Paired sampled t-test was chosen for the statistical investigation for the study. The tests were conducted by comparing means of text, video, and virtual reality learning methodologies in medical students. All executed statistical models are having significance value P=.000. Therefore, results are generalizable and can be implemented across the population. Medical student motivation was observed to be the greatest in Virtual Reality settings as compared to video-based and text-based learning settings. Both theoretical and practical studies have importance in medical studies, whereas practical hand-on-practice can enhance medical students’ professional proficiency. Virtual reality was at the top in User experience, perceived competence, usefulness, and motivation for final year medical students. It can play a signficant role in contemporary teaching and learning methodology with medical educationist and students can get benefit from this technology.

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The Effect of 360° Virtual Reality versus 2-Dimensional Video Reviews on History Taking and Physical Examination Skills Learning in Undergraduate Medical Students: A Randomized Controlled Trial (Preprint)

10.2196/preprints.18173 ◽

2020 ◽

Author(s):

Yi-Ping Chao ◽

Chung-Jan Kang ◽

Ming-Ju Hsieh ◽

Yu-Che Chang ◽

Tuan-Jen Fang ◽

...

Keyword(s):

Virtual Reality ◽

Standard Deviation ◽

Medical Students ◽

Physical Examination ◽

Cognitive Load ◽

Learning Outcome ◽

History Taking ◽

Undergraduate Medical Students ◽

Video Review ◽

Video Group

BACKGROUND History taking and physical examination (H&P) is an important core competency of undergraduate medical education. Recent advances in virtual reality (VR) simulation, lowering the complexity of learning tasks and the cognitive load of the learners, make this novel technology well suited for the initial training of novices. Reduced heart rate variation (HRV) is associated with decreased cognitive efficiency. Whether a 360° VR video review can impact learning outcome, cognitive load, and HRV while learning H&P skills in undergraduate medical students is unknown. OBJECTIVE We explored the effectiveness of 360° VR versus 2-dimensional (2D) video review to learn H&P skills with regards to learning outcome, cognitive load, and HRV. METHODS In 2018, we randomly assigned (1:1) 64 undergraduate medical students to either a 360° VR or 2D video group (matched by age, sex, and cognitive style) with allocation concealment to learn H&P skills using VR headsets and controllers. Subsequently, the participants each performed a focused H&P with a real outpatient. Two raters used the Mini-Clinical Evaluation Exercise (Mini-CEX) and Direct Observation of Procedural Skills (DOPS) questionnaires to assess the participants’ performance blindly. The Cognitive Load Component questionnaire and a portable electrocardiogram monitor were used to measure cognitive load and HRV, respectively. RESULTS All participants completed the study (mean age=24.2 years, standard deviation=0.9 years; 44 [69%] males and 20 [31%] females). The physical examination and student’s satisfaction scores (Mini-CEX), total DOPS score, total and intrinsic cognitive load scores, and standard deviation of normal to normal R-R intervals in the 360° VR video group were significantly higher than those in the 2D video group (effect size=0.63, 0.56, 0.72, 0.53, 0.67, and 0.52, respectively). Differences in the other aspects of the Mini-CEX and cognitive loads of both groups were not statistically significant. CONCLUSIONS This study provides a high level of evidence to confirm that 360° VR video review can help undergraduate medical students to perform fundamental H&P skills as effectively as traditional 2D video review. Furthermore, a 360° VR video review could be used to more efficiently examine the body of a real patient with higher learner’s satisfaction. These findings may inspire the design of 360° VR video-based training protocols to enhance competencies other than history taking. CLINICALTRIAL Clinicaltrials.gov NCT03501641; https://clinicaltrials.gov/ct2/show/NCT03501641 (Archived by WebCite at http://www.webcitation.org/72f59ImWm)

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Using a 360° Virtual Reality or 2D Video to Learn History Taking and Physical Examination Skills for Undergraduate Medical Students: Pilot Randomized Controlled Trial

JMIR Serious Games ◽

10.2196/13124 ◽

2021 ◽

Vol 9 (4) ◽

pp. e13124

Author(s):

Yi-Ping Chao ◽

Hai-Hua Chuang ◽

Li-Jen Hsin ◽

Chung-Jan Kang ◽

Tuan-Jen Fang ◽

...

Keyword(s):

Virtual Reality ◽

Reaction Time ◽

Medical Students ◽

Cognitive Load ◽

Learning Outcomes ◽

History Taking ◽

Undergraduate Medical Students ◽

Qualitative Feedback ◽

Video Group ◽

Video Module

Background Learning through a 360° virtual reality (VR) or 2D video represents an alternative way to learn a complex medical education task. However, there is currently no consensus on how best to assess the effects of different learning materials on cognitive load estimates, heart rate variability (HRV), outcomes, and experience in learning history taking and physical examination (H&P) skills. Objective The aim of this study was to investigate how learning materials (ie, VR or 2D video) impact learning outcomes and experience through changes in cognitive load estimates and HRV for learning H&P skills. Methods This pilot system–design study included 32 undergraduate medical students at an academic teaching hospital. The students were randomly assigned, with a 1:1 allocation, to a 360° VR video group or a 2D video group, matched by age, sex, and cognitive style. The contents of both videos were different with regard to visual angle and self-determination. Learning outcomes were evaluated using the Milestone reporting form. Subjective and objective cognitive loads were estimated using the Paas Cognitive Load Scale, the National Aeronautics and Space Administration Task Load Index, and secondary-task reaction time. Cardiac autonomic function was assessed using HRV measurements. Learning experience was assessed using the AttrakDiff2 questionnaire and qualitative feedback. Statistical significance was accepted at a two-sided P value of <.01. Results All 32 participants received the intended intervention. The sample consisted of 20 (63%) males and 12 (38%) females, with a median age of 24 (IQR 23-25) years. The 360° VR video group seemed to have a higher Milestone level than the 2D video group (P=.04). The reaction time at the 10th minute in the 360° VR video group was significantly higher than that in the 2D video group (P<.001). Multiple logistic regression models of the overall cohort showed that the 360° VR video module was independently and positively associated with a reaction time at the 10th minute of ≥3.6 seconds (exp B=18.8, 95% CI 3.2-110.8; P=.001) and a Milestone level of ≥3 (exp B=15.0, 95% CI 2.3-99.6; P=.005). However, a reaction time at the 10th minute of ≥3.6 seconds was not related to a Milestone level of ≥3. A low-frequency to high-frequency ratio between the 5th and 10th minute of ≥1.43 seemed to be inversely associated with a hedonic stimulation score of ≥2.0 (exp B=0.14, 95% CI 0.03-0.68; P=.015) after adjusting for video module. The main qualitative feedback indicated that the 360° VR video module was fun but caused mild dizziness, whereas the 2D video module was easy to follow but tedious. Conclusions Our preliminary results showed that 360° VR video learning may be associated with a better Milestone level than 2D video learning, and that this did not seem to be related to cognitive load estimates or HRV indexes in the novice learners. Of note, an increase in sympathovagal balance may have been associated with a lower hedonic stimulation score, which may have met the learners’ needs and prompted learning through the different video modules. Trial Registration ClinicalTrials.gov NCT03501641; https://clinicaltrials.gov/ct2/show/NCT03501641

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Improvement of three-dimensional motion sickness using a virtual reality simulator for robot-assisted surgery in undergraduate medical students: A prospective observational study

BMC Medical Education ◽

10.1186/s12909-021-02872-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ryo Takata ◽

Mitsugu Kanehira ◽

Yoichiro Kato ◽

Tomohiko Matsuura ◽

Renpei Kato ◽

...

Keyword(s):

Virtual Reality ◽

Medical Students ◽

Observational Study ◽

Motion Sickness ◽

Prospective Observational Study ◽

Da Vinci ◽

Undergraduate Medical Students ◽

Da Vinci Robot ◽

3D Motion ◽

Vr Simulator

Abstract Background A virtual reality (VR) simulator is utilized as an inexpensive tool for gaining basic technical competence in robotic-assisted surgery (RAS). We evaluated operator 3D motion sickness while using a VR simulator and assessed whether it can be reduced by repeating the training. Methods This prospective observational study was conducted at the Department of Urology, Iwate Medical University, a tertiary training hospital in an urban setting. A total of 30 undergraduate medical students participated in the study. We compared whether the VR simulator improved the students’ skills in operating the da Vinci robot. Fifteen students underwent training with a VR simulator for 4 h a day for 5 days. Then, motion sickness was determined using the Visual Analog Scale and Simulator Sickness Questionnaire (SSQ) before and after the training. Results Manipulation time significantly improved after training compared to before training (293.9 ± 72.4 versus 143.6 ± 18.4 s; p < 0.001). Although motion sickness worsened after each training session, it gradually improved with continuous practice with the VR simulator. SSQ subscores showed that the VR simulator induced nausea, disorientation, and oculomotor strain, and oculomotor strain was significantly improved with repeated training. Conclusions In undergraduate students, practice with the VR simulator improved RAS skills and operator 3D motion sickness caused by 3D manipulation of the da Vinci robot.

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Improvement of three-dimensional motion sickness using a virtual reality simulator for robot-assisted surgery in undergraduate medical students: a prospective observational study

10.21203/rs.3.rs-244402/v1 ◽

2021 ◽

Author(s):

Ryo Takata ◽

Mitsugu Kanehira ◽

Yoichiro Kato ◽

Tomohiko Matsuura ◽

Renpei Kato ◽

...

Keyword(s):

Virtual Reality ◽

Medical Students ◽

Observational Study ◽

Motion Sickness ◽

Prospective Observational Study ◽

Da Vinci ◽

Undergraduate Medical Students ◽

Da Vinci Robot ◽

3D Motion ◽

Vr Simulator

Abstract Background A virtual reality (VR) simulator is utilized as an inexpensive tool for gaining basic technical competence in robotic-assisted surgery (RAS). We evaluated operator 3D motion sickness while using a VR simulator and assessed whether it can be reduced by repeating the training. Methods This prospective observational study was conducted at the Department of Urology, Iwate Medical University, a tertiary level training hospital in an urban setting. A total of 30 undergraduate medical students participated in the study. We compared whether the VR simulator improved the students’ skills in operating the da Vinci robot. Fifteen students underwent training with a VR simulator for 4 hours a day for 5 days. Then, motion sickness was ascertained using the Visual Analog Scale and Simulator Sickness Questionnaire (SSQ) before and after the training. Results Manipulation time significantly improved after training compared to before training (293.9 ± 72.4 versus 143.6 ± 18.4 seconds, p < 0.001). Although motion sickness worsened after each training session, continuous practice with the VR simulator gradually reduced this. SSQ subscores showed that the VR simulator elicited nausea, disorientation, and oculomotor strain, and oculomotor strain was significantly improved with repeated training. Conclusion In undergraduate students, practice with the VR simulator improved the technique of RAS and operator 3D motion sickness caused by 3D manipulation of the da Vinci robot.

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Using a 360° Virtual Reality or 2D Video to Learn History Taking and Physical Examination Skills for Undergraduate Medical Students: Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.13124 ◽

2018 ◽

Author(s):

Yi-Ping Chao ◽

Hai-Hua Chuang ◽

Li-Jen Hsin ◽

Chung-Jan Kang ◽

Tuan-Jen Fang ◽

...

Keyword(s):

Virtual Reality ◽

Reaction Time ◽

Medical Students ◽

Cognitive Load ◽

Learning Outcomes ◽

History Taking ◽

Undergraduate Medical Students ◽

Qualitative Feedback ◽

Video Group ◽

Video Module

BACKGROUND Learning through a 360° virtual reality (VR) or 2D video represents an alternative way to learn a complex medical education task. However, there is currently no consensus on how best to assess the effects of different learning materials on cognitive load estimates, heart rate variability (HRV), outcomes, and experience in learning history taking and physical examination (H&P) skills. OBJECTIVE The aim of this study was to investigate how learning materials (ie, VR or 2D video) impact learning outcomes and experience through changes in cognitive load estimates and HRV for learning H&P skills. METHODS This pilot system–design study included 32 undergraduate medical students at an academic teaching hospital. The students were randomly assigned, with a 1:1 allocation, to a 360° VR video group or a 2D video group, matched by age, sex, and cognitive style. The contents of both videos were different with regard to visual angle and self-determination. Learning outcomes were evaluated using the Milestone reporting form. Subjective and objective cognitive loads were estimated using the Paas Cognitive Load Scale, the National Aeronautics and Space Administration Task Load Index, and secondary-task reaction time. Cardiac autonomic function was assessed using HRV measurements. Learning experience was assessed using the AttrakDiff2 questionnaire and qualitative feedback. Statistical significance was accepted at a two-sided P value of <.01. RESULTS All 32 participants received the intended intervention. The sample consisted of 20 (63%) males and 12 (38%) females, with a median age of 24 (IQR 23-25) years. The 360° VR video group seemed to have a higher Milestone level than the 2D video group (P=.04). The reaction time at the 10th minute in the 360° VR video group was significantly higher than that in the 2D video group (P<.001). Multiple logistic regression models of the overall cohort showed that the 360° VR video module was independently and positively associated with a reaction time at the 10th minute of ≥3.6 seconds (exp B=18.8, 95% CI 3.2-110.8; P=.001) and a Milestone level of ≥3 (exp B=15.0, 95% CI 2.3-99.6; P=.005). However, a reaction time at the 10th minute of ≥3.6 seconds was not related to a Milestone level of ≥3. A low-frequency to high-frequency ratio between the 5th and 10th minute of ≥1.43 seemed to be inversely associated with a hedonic stimulation score of ≥2.0 (exp B=0.14, 95% CI 0.03-0.68; P=.015) after adjusting for video module. The main qualitative feedback indicated that the 360° VR video module was fun but caused mild dizziness, whereas the 2D video module was easy to follow but tedious. CONCLUSIONS Our preliminary results showed that 360° VR video learning may be associated with a better Milestone level than 2D video learning, and that this did not seem to be related to cognitive load estimates or HRV indexes in the novice learners. Of note, an increase in sympathovagal balance may have been associated with a lower hedonic stimulation score, which may have met the learners’ needs and prompted learning through the different video modules. CLINICALTRIAL ClinicalTrials.gov NCT03501641; https://clinicaltrials.gov/ct2/show/NCT03501641

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Assessing the development of communication skills in undergraduate medical students

Medical Education ◽

10.1046/j.1365-2923.2001.00869.x ◽

2001 ◽

Vol 35 (3) ◽

pp. 225-231 ◽

Cited By ~ 58

Author(s):

G M Humphris ◽

S Kaney

Keyword(s):

Medical Students ◽

Communication Skills ◽

Undergraduate Medical Students

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Using SurveyMonkey® to teach safe social media strategies to medical students in their clinical years

Communication & Medicine ◽

10.1558/cam.v11i2.27556 ◽

2015 ◽

Vol 11 (2) ◽

pp. 117-124 ◽

Cited By ~ 5

Author(s):

Katrina A. Bramstedt ◽

Ben Ierna ◽

Victoria Woodcroft-Brown

Keyword(s):

Social Media ◽

Medical Students ◽

Media Ethics ◽

Ethical Awareness ◽

Media Technology ◽

Undergraduate Medical Students ◽

Clinical Rotations ◽

Medical Apps ◽

Practice Of Medicine ◽

Medical Photography

Social media is a valuable tool in the practice of medicine, but it can also be an area of ‘treacherous waters’ for medical students. Those in their upper years of study are off-site and scattered broadly, undertaking clinical rotations; thus, in-house (university lecture) sessions are impractical. Nonetheless, during these clinical years students are generally high users of social media technology, putting them at risk of harm if they lack appropriate ethical awareness. We created a compulsory session in social media ethics (Doctoring and Social Media) offered in two online modes (narrated PowerPoint file or YouTube video) to fourth- and fifth-year undergraduate medical students. The novelty of our work was the use of SurveyMonkey® to deliver the file links, as well as to take attendance and deliver a post-session performance assessment. All 167 students completed the course and provided feedback. Overall, 73% Agreed or Strongly Agreed the course session would aid their professionalism skills and behaviours, and 95% supported delivery of the curriculum online. The most frequent areas of learning occurred in the following topics: email correspondence with patients, medical photography, and awareness of medical apps. SurveyMonkey® is a valuable and efficient tool for curriculum delivery, attendance taking, and assessment activities.

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