Kleinert Robert, Wahba Roger, Chang De-Hua, Plum Patrick, Hölscher Arnulf H, Stippel Dirk L
Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany.
J Med Internet Res. 2015 Apr 8;17(4):e91. doi: 10.2196/jmir.3492.
Immersive patient simulators (IPSs) combine the simulation of virtual patients with a three-dimensional (3D) environment and, thus, allow an illusionary immersion into a synthetic world, similar to computer games. Playful learning in a 3D environment is motivating and allows repetitive training and internalization of medical workflows (ie, procedural knowledge) without compromising real patients. The impact of this innovative educational concept on learning success requires review of feasibility and validity.
It was the aim of this paper to conduct a survey of all immersive patient simulators currently available. In addition, we address the question of whether the use of these simulators has an impact on knowledge gain by summarizing the existing validation studies.
A systematic literature search via PubMed was performed using predefined inclusion criteria (ie, virtual worlds, focus on education of medical students, validation testing) to identify all available simulators. Validation testing was defined as the primary end point.
There are currently 13 immersive patient simulators available. Of these, 9 are Web-based simulators and represent feasibility studies. None of these simulators are used routinely for student education. The workstation-based simulators are commercially driven and show a higher quality in terms of graphical quality and/or data content. Out of the studies, 1 showed a positive correlation between simulated content and real content (ie, content validity). There was a positive correlation between the outcome of simulator training and alternative training methods (ie, concordance validity), and a positive coherence between measured outcome and future professional attitude and performance (ie, predictive validity).
IPSs can promote learning and consolidation of procedural knowledge. The use of immersive patient simulators is still marginal, and technical and educational approaches are heterogeneous. Academic-driven IPSs could possibly enhance the content quality, improve the validity level, and make this educational concept accessible to all medical students.
沉浸式患者模拟器（IPS）将虚拟患者模拟与三维（3D）环境相结合，从而能营造出一种仿佛置身于虚拟世界的沉浸感，类似于电脑游戏。在3D环境中进行趣味性学习很有吸引力，并且能在不危及真实患者的情况下，对医疗工作流程（即程序性知识）进行反复训练和内化。这一创新教育理念对学习成效的影响需要对其可行性和有效性进行评估。
本文旨在对目前所有可用的沉浸式患者模拟器进行一项调查。此外，我们通过总结现有的验证研究来探讨使用这些模拟器是否对知识获取有影响。
通过PubMed进行系统的文献检索，使用预先定义的纳入标准（即虚拟世界、侧重于医学生教育、验证测试）来识别所有可用的模拟器。验证测试被定义为主要终点。
目前有13种沉浸式患者模拟器。其中，9种是基于网络的模拟器，均为可行性研究。这些模拟器均未常规用于学生教育。基于工作站的模拟器是商业驱动的，在图形质量和/或数据内容方面质量更高。在这些研究中，有1项显示模拟内容与实际内容之间存在正相关（即内容效度）。模拟器训练结果与其他训练方法之间存在正相关（即一致性效度），并且测量结果与未来专业态度和表现之间存在正相关（即预测效度）。
IPS可以促进程序性知识的学习和巩固。沉浸式患者模拟器的使用仍然较少，技术和教育方法也各不相同。学术驱动的IPS可能会提高内容质量，提升效度水平，并让所有医学生都能接触到这一教育理念。
