Luiz Thomas, Elsenbast Christian, Breckwoldt Jan
Digital Healthcare, Fraunhofer IESE, Fraunhofer-Platz 1, 67663, Kaiserslautern, Deutschland.
Institut für Anästhesiologie, Universitätsspital Zürich, Zürich, Schweiz.
Anaesthesiologie. 2023 Aug;72(8):596-607. doi: 10.1007/s00101-023-01305-0. Epub 2023 Jun 30.
Simulation training is indispensable in emergency medicine, especially for enhancing patient safety. Methods and technologies used include a wide spectrum ranging from simple skill trainers to complex full-scale simulated environments integrating standardized patient actors. Limitations include the simulation of dynamic changes of clinical symptoms, the depiction of emotions and patient movements as well as complex environments, such as lively traffic. Extended reality (XR) holds the potential to overcome these limitations.
METHODS/AIMS: Starting with the technological basis and the didactic considerations in the field of XR, the paper reflects the potentials and limitations of this new technology in the domain of medical simulation training. Further focus is put on the integration of XR into existing training curricula.
The XR covers various technologies, ranging from PC-based applications that are similar to conventional computer games, over virtual realities enabling spatially freely navigable 3‑dimensional simulation (using closed 3D glasses: head mounted displays, HMD), to mixed-reality applications that combine virtual elements and real physical objects; however, technology alone does not stimulate learning. As with other simulation methods, it is crucial with XR to implement learning objectives, methods and technologies in a suitable teaching-learning arrangement and to familiarize teachers and students with the new technology. Evidence in the literature with respect to learning success is limited by the heterogeneity of technologies, target groups, teaching-learning arrangements and learning outcomes. Overall, significant increases can be shown for the intrinsic motivation of learners, and for high emotional participation (measured as perceived presence in the virtual environment).
Technological developments and the increasing use of digital media in emergency medical education and training favor the leap from XR-based pure demonstration projects to educational practice. Decisive for the educational success are the clear orientation towards concrete learning goals and a thorough familiarization with the new technology.
Simulation training based on XR expands the spectrum of existing simulation methods to integrate new dimensions of learning objectives. Further research on the effectiveness of this method is needed.
模拟训练在急诊医学中不可或缺，尤其是对于提高患者安全。所使用的方法和技术范围广泛，从简单的技能训练器到整合标准化患者角色的复杂全尺寸模拟环境。局限性包括临床症状动态变化的模拟、情绪及患者动作的描绘以及复杂环境（如繁忙交通）的呈现。扩展现实（XR）有潜力克服这些局限性。
方法/目的：本文从XR领域的技术基础和教学考量出发，探讨了这项新技术在医学模拟训练领域的潜力和局限性。进一步聚焦于将XR融入现有训练课程。
XR涵盖多种技术，从类似于传统电脑游戏的基于PC的应用程序，到能实现空间自由导航的三维模拟的虚拟现实（使用封闭式3D眼镜：头戴式显示器，HMD），再到结合虚拟元素和真实物理对象的混合现实应用程序；然而，单靠技术并不能促进学习。与其他模拟方法一样，对于XR来说，在合适的教学安排中实施学习目标、方法和技术，并让教师和学生熟悉这项新技术至关重要。文献中关于学习成功的证据因技术、目标群体、教学安排和学习成果的异质性而受到限制。总体而言，学习者的内在动机以及高情感参与度（以在虚拟环境中的临场感来衡量）有显著提高。
技术发展以及数字媒体在急诊医学教育与培训中的日益使用，有利于从基于XR的纯示范项目向教育实践的跨越。教育成功的关键在于明确以具体学习目标为导向，并彻底熟悉这项新技术。
基于XR的模拟训练扩展了现有模拟方法的范围，以纳入学习目标的新维度。需要对该方法的有效性进行进一步研究。
