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

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.

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

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.

scholarly journals Utilization of a Voice-Based Virtual Reality Advanced Cardiac Life Support Team Leader Refresher: Prospective Observational Study

10.2196/17425 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e17425
Author(s):  
Daniel Katz ◽  
Ronak Shah ◽  
Elizabeth Kim ◽  
Chang Park ◽  
Anjan Shah ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Life Support ◽  
Survival Rates ◽  
Cost Effective ◽  
Advanced Cardiac Life Support ◽  
The United States ◽  
Team Leader ◽  
Cost Comparison

Background The incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of training are expensive, time consuming, and difficult to scale, which necessitates improvements in advanced cardiac life support (ACLS) training. Virtual reality (VR) has been proposed as an alternative or adjunct to high-fidelity simulation (HFS) in several environments. No evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills and demonstrate a cost comparison. Objective This study aimed to explore the utility of a voice-based VR ACLS team leader refresher as compared with HFS. Methods This prospective observational study performed at an academic institution consisted of 25 postgraduate year 2 residents. Participants were randomized to HFS or VR training and then crossed groups after a 2-week washout. Participants were graded on technical and nontechnical skills. Participants also completed self-assessments about the modules. Proctors were assessed for fatigue and task saturation, and cost analysis based on local economic data was performed. Results A total of 23 of 25 participants were included in the scoring analysis. Fewer participants were familiar with VR compared with HFS (9/25, 36% vs 25/25, 100%; P<.001). Self-reported satisfaction and utilization scores were similar; however, significantly more participants felt HFS provided better feedback: 99 (IQR 89-100) vs 79 (IQR 71-88); P<.001. Technical scores were higher in the HFS group; however, nontechnical scores for decision making and communication were not significantly different between modalities. VR sessions were 21 (IQR 19-24) min shorter than HFS sessions, the National Aeronautics and Space Administration task load index scores for proctors were lower in each category, and VR sessions were estimated to be US $103.68 less expensive in a single-learner, single-session model. Conclusions Utilization of a VR-based team leader refresher for ACLS skills is comparable with HFS in several areas, including learner satisfaction. The VR module was more cost-effective and was easier to proctor; however, HFS was better at delivering feedback to participants. Optimal education strategies likely contain elements of both modalities. Further studies are needed to examine the utility of VR-based environments at scale.

Prospective observational study on chemotherapy-induced nausea and vomiting (CINV) for colorectal cancer patients by the CINV study group of Japan.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 652-652
Author(s):  
Yuji Miyamoto ◽  
Hideo Baba ◽  
Yasushi Tsuji ◽  
Ayako Doi ◽  
Koji Takeda ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Observational Study ◽  
Receptor Antagonist ◽  
Motion Sickness ◽  
Prospective Observational Study ◽  
Incidence Rates ◽  
Nausea And Vomiting ◽  
Acute Nausea ◽  
Delayed Nausea ◽  
Acute Cinv

652 Background: The aim of this study is to investigate the incidence of Chemotherapy Induced Nausea and Vomiting (CINV) among moderately emetogenic chemotherapy-naive patients with colorectal cancer. We also assessed whether the medical staff accurately recognized the incidence of CINV in their own practices. Methods: A prospective observational study of patients receiving the first cycle of oxaliplatin or irinotecan-based chemotherapy was performed. A 7-day diary for CINV was provided to the patients prior to chemotherapy to record daily incidence of CINV. Observed incidence rates of acute (day1) and delayed (days 2-7) CINV were compared with medical staff's predictions. Results: A total of 191 patients (110 males and 81 females) were registered during the period from April 2011 to December 2012. All patients were treated with oxaliplatin-based (n = 175) or irinotecan-based chemotherapy (n = 16). Acute vomiting was observed in 4 patients (2.1%), while delayed vomiting was observed in 19 patients (10.0%). Acute nausea occurred in 14 patients (7.3%), while 63 patients (33%) were affected by delayed nausea. Irinotecan significantly induced acute nausea more frequently than oxaliplatin did (p = 0.019). The presence of motion sickness was significantly associated with the incidence of acute nausea (p < 0.001) and vomiting (p = 0.003). Antiemetics were given along the guideline to all patients. 58 patients were administered a neurokinin-1 (NK1) receptor antagonist. Patients with NK-1 receptor antagonist showed significantly less incidence of delayed vomiting than patients without one (3% vs 13%, p = 0.048). 30 patients (15.7%) required rescue antiemetics. The staff had estimated the incidence of acute CINV in 91 patients (47.6%). However, only 14 patients (7.3%) really experienced acute CINV. Conclusions: CINV seems to be controllable with appropriate management, but delayed CINV still remains an important problem to be targeted. The presence of motion sickness should be affected by efficient antiemetic management. The extent of CINV in this patient group seems to be overestimated.

scholarly journals 5-Hydroxytryptamine-3 Receptor Antagonist and Dexamethasone as Prophylaxis for Chemotherapy-Induced Nausea and Vomiting During Moderately Emetic Chemotherapy for Solid Tumors: A Multicenter, Prospective, Observational Study

2020 ◽  
Author(s):  
Reiko Matsui ◽  
Kenichi Suzuki ◽  
Tomomi Takiguchi ◽  
Makoto Nishio ◽  
Takeshi Koike ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Observational Study ◽  
Receptor Antagonist ◽  
Motion Sickness ◽  
Prospective Observational Study ◽  
Nausea And Vomiting ◽  
Complete Control ◽  
History Of ◽  
Multicenter Prospective Observational Study

Abstract Background: Of patients receiving moderate emetic risk chemotherapy (MEC), 30%–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial. Methods: In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. Results: Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51% and 61% of patients, respectively. Logistic regression analysis revealed history of motion sickness, history of pregnancy-associated vomiting and CBDCA-based chemotherapy as risk factors for CR and history of motion sickness and history of pregnancy-associated vomiting as risk factors for TC. Additional, Ages ≥65 years is an independent predictive factor for achieving TC. Conclusion: Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5)+ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.

scholarly journals Motivating Medical Students Using Virtual Reality Based Education

2020 ◽  
Vol 15 (02) ◽  
pp. 160 ◽  
Author(s):  
Mian Usman Sattar ◽  
Sellappan Palaniappan ◽  
Asiah Lokman ◽  
Nauman Shah ◽  
Usman Khalid ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Student Motivation ◽  
Teaching And Learning ◽  
Statistical Investigation ◽  
Learning Motivation ◽  
Medical Studies ◽  
Undergraduate Medical Students ◽  
Training Simulation ◽  
Intrinsic Motivation Inventory

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.

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)

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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