Mill Tobias, Parikh Shefali, Allen Archie, Dart Gemma, Lee Daniel, Richardson Charlotte, Howell Keith, Lewington Andrew
Medical Education Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
BMJ Simul Technol Enhanc Learn. 2021 May 25;7(6):494-500. doi: 10.1136/bmjstel-2021-000864. eCollection 2021.
The COVID-19 pandemic resulted in a loss of clinical clerkship opportunities for medical students. To address this problem while maintaining patient safety, this pilot study explored the feasibility of using a wearable headset to live stream teaching ward rounds to remotely based medical students.
Three live streamed teaching ward rounds were delivered to three groups of medical students (n=53) using the Microsoft HoloLens 2 device and Microsoft Teams software, and results pooled for analysis. Feedback was gathered from students and instructors using the evaluation of technology-enhanced learning materials (ETELM). Patient feedback was gathered using the Communication Assessment Tool to explore any impact on interpersonal communication.
The response rate for the ETELM-learner perceptions was 58% (31/53), 100% for the ETELM-instructor perceptions. Students strongly agreed that the overall quality of the teaching session and instructors was excellent. However, 32% experienced issues with audio or video quality and one remote student reported cyber sickness. The statement 'educational activities encouraged engagement with session materials/content' returned the most varied response. Instructors reported technological problems with delivery while using the HoloLens 2 device and environmental noise in the ward was a disruptive factor. Preparation and skilled facilitation were key to delivering a high-quality teaching session. Patients reacted generally favourably to the technology and no negative effects on interpersonal communication were identified.
The experience of live streamed ward rounds was well received by patients, medical students and teaching faculty. However, there remain limitations to the routine use of HoloLens 2 technology in our setting including steep learning curves, hardware costs and environmental factors such as noise and WiFi connectivity. Live streamed ward rounds have potential postpandemic implications for the judicious use of resources, and the possibility for few educationally minded clinicians to teach at scale in a patient-friendly manner.
新冠疫情导致医学生失去了临床实习机会。为在确保患者安全的同时解决这一问题，本试点研究探讨了使用可穿戴头戴式设备向远程医学生直播教学查房的可行性。
使用微软HoloLens 2设备和微软Teams软件，为三组医学生（n = 53）进行了三次直播教学查房，并汇总结果进行分析。通过技术增强学习材料评估（ETELM）收集学生和教师的反馈。使用沟通评估工具收集患者反馈，以探讨对人际沟通的任何影响。
ETELM-学习者认知的回复率为58%（31/53），ETELM-教师认知的回复率为100%。学生们强烈认为教学课程和教师的整体质量非常出色。然而，32%的学生遇到了音频或视频质量问题，一名远程学生报告出现了网络病。“教育活动鼓励参与课程材料/内容”这一陈述的回复差异最大。教师报告在使用HoloLens 2设备进行授课时存在技术问题，病房内的环境噪音是一个干扰因素。准备工作和熟练的引导是进行高质量教学课程的关键。患者对该技术总体反应良好，未发现对人际沟通有负面影响。
患者、医学生和教师对直播教学查房的体验评价良好。然而，在我们的环境中，HoloLens 2技术的常规使用仍存在局限性，包括学习曲线陡峭、硬件成本以及噪音和WiFi连接等环境因素。直播教学查房在疫情后对资源的合理利用具有潜在影响，并且少数有教育意识的临床医生有可能以患者友好的方式进行大规模教学。
