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虚拟现实在医学院急诊医学培训中的应用:前瞻性、大样本实施研究。

Virtual Reality for Emergency Medicine Training in Medical School: Prospective, Large-Cohort Implementation Study.

机构信息

Tübingen Institute for Medical Education (TIME), Eberhard Karls University, Tübingen, Germany.

Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.

出版信息

J Med Internet Res. 2023 Mar 3;25:e43649. doi: 10.2196/43649.

DOI:10.2196/43649
PMID:36867440
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10024212/
Abstract

BACKGROUND

Virtual reality (VR)-based simulation is being increasingly used to train medical students in emergency medicine. However, because the usefulness of VR may depend on various factors, the best practices for implementing this technology in the medical school curriculum are yet to be determined.

OBJECTIVE

The overall objective of our study was to assess the perceptions of a large cohort of students toward VR-based training and to identify the associations between these attitudes and individual factors, such as gender and age.

METHODS

The authors implemented a voluntary, VR-based teaching session in the emergency medicine course at the Medical Faculty in Tübingen, Germany. Fourth-year medical students were invited to participate on a voluntary basis. Afterward, we asked the students about their perceptions, collected data on individual factors, and assessed the test scores achieved by them in the VR-based assessment scenarios. We used ordinal regression analysis and linear mixed-effects analysis to detect the impact of individual factors on the questionnaire answers.

RESULTS

A total of 129 students participated in our study (mean age 24.7, SD 2.9 years; n=51, 39.8% male; n=77, 60.2% female). No student had previously used VR for learning, and only 4.7% (n=6) of the students had prior experience with VR. Most of the students agreed that VR can convey complex issues quickly (n=117, 91%), that VR is a useful addition to mannequin-based courses (n=114, 88%) or could even replace them (n=93, 72%), and that VR simulations should also be used for examinations (n=103, 80%). However, female students showed significantly less agreement with these statements. Most students perceived the VR scenario as realistic (n=69, 53%) and intuitive (n=62, 48%), with a relatively lower agreement for the latter among female respondents. We found high agreement among all participants (n=88, 69%) for immersion but strong disagreement (n=69, 54%) for empathy with the virtual patient. Only 3% (n=4) of the students felt confident regarding the medical content. Responses for the linguistic aspects of the scenario were largely mixed; however, most of the students were confident with the English language (not native) scenarios and disagreed that the scenario should be offered in their native language (female students agreed more strongly than male students). Most of the students would not have felt confident with the scenarios in a real-world context (n=69, 53%). Although physical symptoms during VR sessions were reported by 16% (n=21) of the respondents, this did not lead to the termination of the simulation. The regression analysis revealed that the final test scores were not influenced by gender, age, or prior experience in emergency medicine or with virtual reality.

CONCLUSIONS

In this study, we observed a strong positive attitude in medical students toward VR-based teaching and assessment. However, this positivity was comparatively lower among female students, potentially indicating that gender differences need to be addressed when VR is implemented in the curriculum. Interestingly, gender, age, or prior experience did not influence the final test scores. Furthermore, confidence regarding the medical content was low, which suggests that the students may need further training in emergency medicine.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/32ec35379cb3/jmir_v25i1e43649_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/6365d5d06b86/jmir_v25i1e43649_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/484c3556befb/jmir_v25i1e43649_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/7248ead6fd33/jmir_v25i1e43649_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/32ec35379cb3/jmir_v25i1e43649_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/6365d5d06b86/jmir_v25i1e43649_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/484c3556befb/jmir_v25i1e43649_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/7248ead6fd33/jmir_v25i1e43649_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec71/10024212/32ec35379cb3/jmir_v25i1e43649_fig4.jpg
摘要

背景

虚拟现实(VR)模拟技术正越来越多地被用于急诊医学专业医学生的培训。然而,由于 VR 的有效性可能取决于多种因素,因此在医学院课程中实施这项技术的最佳实践仍有待确定。

目的

我们研究的总体目标是评估大量医学生对基于 VR 的培训的看法,并确定这些态度与性别和年龄等个体因素之间的关联。

方法

作者在德国图宾根医学系的急诊医学课程中实施了一项基于 VR 的教学课程。邀请四年级医学生自愿参加。之后,我们询问了学生的看法,收集了个人因素数据,并评估了他们在基于 VR 的评估场景中取得的测试成绩。我们使用有序回归分析和线性混合效应分析来检测个体因素对问卷答案的影响。

结果

共有 129 名学生参加了我们的研究(平均年龄 24.7 岁,标准差 2.9 岁;男性 51 名,占 39.8%;女性 77 名,占 60.2%)。没有学生之前使用过 VR 进行学习,只有 4.7%(n=6)的学生有过 VR 体验。大多数学生认为 VR 可以快速传达复杂问题(n=117,91%),是基于人体模型课程的有用补充(n=114,88%),甚至可以替代它们(n=93,72%),并且 VR 模拟也应该用于考试(n=103,80%)。然而,女学生的认同度明显较低。大多数学生认为 VR 场景具有现实性(n=69,53%)和直观性(n=62,48%),而女学生对后者的认同度相对较低。我们发现,所有参与者(n=88,69%)对沉浸感的认同度都很高,但对虚拟患者的同理心的认同度较低(n=69,54%)。只有 3%(n=4)的学生对医学内容有信心。对于场景的语言方面的回答则存在较大差异;然而,大多数学生对英语(非母语)场景有信心,不同意使用母语提供场景(女学生比男学生更强烈地表示不同意)。大多数学生在现实世界环境中不会对场景有信心(n=69,53%)。尽管有 16%(n=21)的受访者在 VR 期间报告了身体症状,但这并没有导致模拟的终止。回归分析显示,最终测试成绩不受性别、年龄、急诊医学或虚拟现实经验的影响。

结论

在这项研究中,我们观察到医学生对基于 VR 的教学和评估表现出强烈的积极态度。然而,女学生的这种积极性相对较低,这可能表明在课程中实施 VR 时需要解决性别差异问题。有趣的是,性别、年龄或先前的经验并不影响最终的测试成绩。此外,学生对医学内容的信心较低,这表明学生可能需要进一步接受急诊医学培训。

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