Mok Tsz-Ngai, Chen Junyuan, Pan Jinghua, Ming Wai-Kit, He Qiyu, Sin Tat-Hang, Deng Jialin, Li Jieruo, Zha Zhengang
Institute of Orthopedics Diseases and Center for Joint Surgery and Sports Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of General Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.
JMIR Serious Games. 2021 Jul 12;9(3):e27544. doi: 10.2196/27544.
Virtual reality (VR) simulators have become widespread tools for training medical students and residents in medical schools. Students using VR simulators are provided with a 3D human model to observe the details by using multiple senses and they can participate in an environment that is similar to reality.
The aim of this study was to promote a new approach consisting of a shared and independent study platform for medical orthopedic students, to compare traditional tendon repair training with VR simulation of tendon repair, and to evaluate future applications of VR simulation in the academic medical field.
In this study, 121 participants were randomly allocated to VR or control groups. The participants in the VR group studied the tendon repair technique via the VR simulator, while the control group followed traditional tendon repair teaching methods. The final assessment for the medical students involved performing tendon repair with the "Kessler tendon repair with 2 interrupted tendon repair knots" (KS) method and the "Bunnell tendon repair with figure 8 tendon repair" (BS) method on a synthetic model. The operative performance was evaluated using the global rating scale.
Of the 121 participants, 117 participants finished the assessment and 4 participants were lost to follow-up. The overall performance (a total score of 35) of the VR group using the KS method and the BS method was significantly higher (P<.001) than that of the control group. Thus, participants who received VR simulator training had a significantly higher score on the global rating scale than those who received traditional tendon repair training (P<.001).
Our study shows that compared with the traditional tendon repair method, the VR simulator for learning tendon suturing resulted in a significant improvement of the medical students in the time in motion, flow of operation, and knowledge of the procedure. Therefore, VR simulator development in the future would most likely be beneficial for medical education and clinical practice.
Chinese Clinical Trial Registry ChiCTR2100046648; http://www.chictr.org.cn/hvshowproject.aspx?id=90180.
虚拟现实（VR）模拟器已成为医学院校培训医学生和住院医师的广泛使用的工具。使用VR模拟器的学生可以通过使用多种感官来观察一个3D人体模型的细节，并且他们能够参与到一个类似于现实的环境中。
本研究的目的是推广一种由医学骨科学生共享且独立的学习平台组成的新方法，比较传统肌腱修复训练与肌腱修复的VR模拟，并评估VR模拟在学术医学领域的未来应用。
在本研究中，121名参与者被随机分配到VR组或对照组。VR组的参与者通过VR模拟器学习肌腱修复技术，而对照组采用传统的肌腱修复教学方法。医学生的最终评估包括在一个合成模型上使用“2个间断肌腱修复结的Kessler肌腱修复法”（KS）和“8字肌腱修复的Bunnell肌腱修复法”（BS）进行肌腱修复。使用整体评分量表评估手术操作表现。
121名参与者中，117名完成了评估，4名失访。使用KS法和BS法的VR组的总体表现（总分35分）显著高于对照组（P<0.001）。因此，接受VR模拟器训练的参与者在整体评分量表上的得分显著高于接受传统肌腱修复训练的参与者（P<0.001）。
我们的研究表明，与传统肌腱修复方法相比，用于学习肌腱缝合的VR模拟器在操作时间、手术流程和手术知识方面使医学生有了显著提高。因此，未来VR模拟器的开发很可能对医学教育和临床实践有益。
中国临床试验注册中心ChiCTR2100046648；http://www.chictr.org.cn/hvshowproject.aspx?id=90180。
