A. Salavitabar is assistant professor of pediatrics, The Heart Center, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio. At the time this initiative was conducted, he was assistant professor of pediatrics, University of Michigan Congenital Heart Center, C.S. Mott Children's Hospital, Ann Arbor, Michigan.
V. Popov is assistant professor of learning health sciences, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan.
Acad Med. 2022 Jul 1;97(7):1017-1020. doi: 10.1097/ACM.0000000000004636. Epub 2022 Jun 23.
While bedside training has always presented its own unique challenges, the COVID-19 pandemic era has intensified barriers to suitable provider and trainee experiences for both patient care and medical education.
This project introduced an innovative solution with the Extended Reality International Grand Rounds, a collaboration between the University of Michigan Center for Medical and Surgical Extended Reality and Imperial College London. Three complex cases were presented to trainees through a wireless, extended reality (XR) headset and augmented by holographic visual aids and expert commentary. This pilot rounding experience was performed through the first-person view of one clinician at the bedside.
In 2020, 140 attendees participated in XR International Grand Rounds, and 82 (59%) and 61 (44%) completed pre- and postsurveys, respectively. Survey analysis showed that the majority of respondents (65, 79.3%) had very little to no baseline experience with XR technologies and nearly all (75, 91.5%) agreed that the development and implementation of XR curricula are important in medical training, indicating an unmet need. Nearly all respondents (59, 96.7%) found value in the ability to visualize patients' clinical findings in the XR rounding experience and 60 (98.4%) found value in the ability to visualize patient-specific imaging and test findings in an XR format. Limiting exposure to high-risk patients and care team members with this innovative format was believed to be important to 79 (96.3%) respondents at baseline and that perception was unchanged following the event.
This solution to a long-standing dilemma, newly stressed by a unique era in medicine, was a successful collaboration using state-of-the-art XR technology. Next steps will include introducing more advanced physical exam visualization and detection and comprehensive evaluation of the patient experience, as well as expanding the international experience in a format that is scalable to other interested institutions.
尽管床边培训一直存在其独特的挑战，但 COVID-19 大流行时期加剧了患者护理和医学教育中合适的医疗提供者和受训者体验的障碍。
该项目引入了一种创新的解决方案，即通过密歇根大学医疗和外科扩展现实中心与伦敦帝国理工学院之间的合作，开展了扩展现实国际大查房。通过无线扩展现实 (XR) 耳机向受训者展示了三个复杂病例，并通过全息视觉辅助和专家评论进行了增强。这次床边试点查房体验是通过一名临床医生的第一人称视角进行的。
2020 年，有 140 名参与者参加了 XR 国际大查房，82 名（59%）和 61 名（44%）分别完成了预调查和后调查。调查分析显示，大多数受访者（65 名，79.3%）几乎没有或没有 XR 技术的基线经验，几乎所有人（75 名，91.5%）都同意在医学培训中开发和实施 XR 课程非常重要，这表明存在未满足的需求。几乎所有受访者（59 名，96.7%）都认为在 XR 查房体验中可视化患者临床发现的能力有价值，而 60 名（98.4%）认为以 XR 格式可视化患者特定的影像学和检测结果有价值。有 79 名（96.3%）受访者认为，在这种创新模式下，限制对高风险患者和护理团队成员的接触很重要，而这一观点在活动结束后并未改变。
这种长期存在的困境的解决方案，在医学的独特时代中受到了新的强调，是使用最先进的 XR 技术成功合作的结果。下一步将包括引入更先进的体格检查可视化和检测，以及全面评估患者体验，同时以可扩展到其他感兴趣机构的格式扩大国际经验。
