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

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

scholarly journals 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)

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&amp;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&amp;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 <i>P</i> value of &lt;.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 (<i>P</i>=.04). The reaction time at the 10th minute in the 360° VR video group was significantly higher than that in the 2D video group (<i>P</i>&lt;.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; <i>P</i>=.001) and a Milestone level of ≥3 (exp B=15.0, 95% CI 2.3-99.6; <i>P</i>=.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; <i>P</i>=.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

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)

scholarly journals Comparison of the effectiveness of lecture instruction and virtual reality-based serious gaming instruction on the medical students’ learning outcome about approach to coma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meysam Siyah Mansoory ◽  
Mohammad Rasool Khazaei ◽  
Seyyed Mohsen Azizi ◽  
Elham Niromand
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Learning Outcomes ◽  
Learning Outcome ◽  
Serious Game ◽  
Control Group ◽  
Serious Gaming ◽  
E Learning ◽  
The Mean ◽  
Lecture Instruction

Abstract Background New approaches to e-learning and the use of virtual reality technology and serious game in medical education are on the rise. Therefore, the purpose of this study was to compare the effectiveness of lecture method and virtual reality-based serious gaming (VRBSG) method on students learning outcomes about the approach to coma. Methods We adopted a randomized trial method for this study and selected 50 medical students dividing them into experimental and control groups. Students’ learning outcome was measured with a 10-item test. Serious game usability scale was used to evaluate the usability of the serious game. Descriptive and inferential statistics were used for data analysis by SPSS-22 software. Results Students’ familiarity with e-learning and VRBSG was low. The mean usability of a VRBSG was 126.78 ± 10.34 out of 150. The majority of students were eager to be instructed through VRBSG. The mean score of learning outcomes in the experimental group was significantly higher than the control group (t = − 2.457, P = 0.019). Conclusion Students’ learning outcomes in the VRBSG group in the test approach to coma were significantly better than the lecture group. The usability of the serious game instruction method was high. Taken together, instruction through VRBSG had an effective role in medical students’ learning.

Replicating Anatomical Teaching Specimens using 3D Modelling Embedded within a Multimodal E-Learning Course: A Pre/Post Study Exploring the Impact on Medical Education during COVID-19 (Preprint)

2021 ◽  
Author(s):  
Chelsea Stunden ◽  
Sima Zakani ◽  
Avery Martin ◽  
Shreya Moodley ◽  
John Jacob
Keyword(s):  
Medical Students ◽  
Learning Outcomes ◽  
Test Scores ◽  
Student Attitudes ◽  
Congenital Heart ◽  
Secondary Outcome ◽  
First Year ◽  
Undergraduate Medical Students ◽  
E Learning ◽  
The Impact

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had significant effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal way of learning anatomy. We created and tested a customized congenital heart disease e-learning course for medical students that contained interactive 3D models of anonymized pediatric congenital heart defects. OBJECTIVE To assess if a multimodal e-learning course contributed to learning outcomes in a cohort of first year undergraduate medical students study congenital heart diseases. Secondarily, we assess student attitudes and experiences associated with multimodal e-learning. METHODS The pre/post study design involved 290 first year undergraduate medical students. Recruitment was conducted through the course instructors. Data were collected before using the course and after using the course. The primary outcome was knowledge acquisition (test scores). The secondary outcome included attitudes and experiences, as well as time to complete the modules, and browser metadata. RESULTS A total of 141 students were included in the final analysis (N=141). Students’ knowledge significantly improved by an average of 44.6% when using the course (SD 1.73, Z = -10.287, p < 0.001). 88.26% of students were highly motivated to learn with the course and 93.5% of students reported positive experiences with the course. There was a strong correlation between attitudes and experiences, which was statistically significant (rs = 0.687, p<0.001, N = 122). There were no relationships found between change test scores and attitudes or experiences (p>0.05). Students most frequently completed the e-learning course with Chrome (77.3%), and on Apple MacOS (61.0%) or Windows 10 (36.9%). Most students had devices with high-definition screens (83.0%). Most students (58.9%) completed the course in under 3 hours. CONCLUSIONS Multi-modal e-learning could be a viable solution to improving learning outcomes and experiences for undergraduate medical students, who do not have access to cadavers. Future research should focus on validating long-term learning outcomes. CLINICALTRIAL n/a

scholarly journals No difference in learning outcomes and usability between using controllers and hand tracking during a virtual reality endotracheal intubation training for medical students in Thailand

2021 ◽  
Vol 18 ◽  
pp. 22
Author(s):  
Chaowanan Khundam ◽  
Naparat Sukkriang ◽  
Frédéric Noël
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Learning Outcomes ◽  
Endotracheal Intubation ◽  
User Satisfaction ◽  
Clinical Training ◽  
Medical Training ◽  
Hand Tracking ◽  
System Usability Scale ◽  
Post Test

Purpose: We developed a virtual reality (VR) endotracheal intubation training that applied 2 interaction modalities (hand-tracking or controllersIt aimed to investigatedthe differences of usuability between using hand tracking and controllers during the VR intervention for intubation training for medical students from February 2021 to March 2021 in Thailand.Methods: Forty-five participants were divided into 3 groups: video only, video with VR controller training, and video with VR hand tracking training. Pre-test, post-test, and practice scores were used to assess learning outcomes. The System Usability Scale (SUS) and User Satisfaction Evaluation Questionnaire (USEQ) questionnaires were used to evaluate the differences between the VR groups. The sample comprised 45 medical students (undergraduate) who were taking part in clinical training at Walailak University in Thailand.Results: The overall learning outcomes of both VR groups were better than those of the video group. The post-test scores (P=0.581) and practice scores (P=0.168) of both VR groups were not significantly different. Similarly, no significant between-group differences were found in the SUS scores (P=0.588) or in any aspects of the USEQ scores.Conclusion: VR enhanced medical training. Interactions using hand tracking or controllers were not significantly different in terms of the outcomes measured in this study. The results and interviews provided a better understanding of support learning and training, which will be further improved and developed to create a self-learning VR medical training system in the future.

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.

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