Rainforth Christopher, John Aneeta, Brown Alison
Medicine, Great Western Hospitals NHS Foundation Trust, Swindon, GBR.
Cureus. 2024 Nov 17;16(11):e73847. doi: 10.7759/cureus.73847. eCollection 2024 Nov.
Doctors in training make substantial contributions to ward rounds. Despite this, formal education in this area is lacking, leading to diminished confidence and competence among undergraduate students and trainees. Ward round-based simulation (WRBS) has shown promise in improving clinical and decision-making skills. This quasi-experimental mixed-methods study aims to explore student experiences of augmented reality (AR) in simulated medical ward rounds. Specifically, it seeks to compare AR to existing traditional simulation modalities (TSM), manikin, and actor, to evaluate its viability as an alternative and to explore the impact of a mixed-modality simulated ward round on student confidence levels in performing ward round tasks.
Fourteen participants engaged in a simulated ward round involving three cases: an actor as a patient, a manikin, and an AR case. Guided by pre- and post-simulation questionnaires, confidence levels around WRBS were explored using Wilcoxon's signed-rank test. Additionally, thematic analysis of semi-structured focus groups explored the use of AR in simulation compared to TSM.
Significant improvements in confidence shown through the pre- and post-simulation questionnaires (p < 0.019) were found using Wilcoxon's signed-rank test across all 11 questions, with effect sizes (r) ranging from 0.65 to 0.9. The highest effect size observed (r = 0.9) asked about the change in confidence when starting or stopping medications during a ward round (p = 0.002). Qualitative analysis of focus group discussions identified key themes such as the visual accuracy of AR, the need for interactivity, and the cognitive load of mixed-method simulations.
The findings suggest that AR can significantly enhance medical training by providing realistic and immersive learning experiences, although further refinements are necessary to improve interactivity and reduce cognitive demands. This study highlights the potential for integrating innovative technologies to better prepare students for clinical practise and provides further insight into the practicalities of using AR in medical education.
正在接受培训的医生对查房做出了重大贡献。尽管如此，这一领域的正规教育却很缺乏，导致本科生和实习生的信心和能力有所下降。基于查房的模拟（WRBS）已显示出在提高临床和决策技能方面的潜力。这项准实验性混合方法研究旨在探索学生在模拟医疗查房中对增强现实（AR）的体验。具体而言，它试图将AR与现有的传统模拟方式（TSM）、人体模型和演员进行比较，以评估其作为替代方案的可行性，并探讨混合模式模拟查房对学生执行查房任务时信心水平的影响。
14名参与者参与了一次模拟查房，其中包括三个病例：一名演员扮演患者、一个人体模型和一个AR病例。在模拟前后问卷的指导下，使用威尔科克森符号秩检验探索围绕WRBS的信心水平。此外，对半结构化焦点小组的主题分析探讨了与TSM相比，AR在模拟中的使用情况。
使用威尔科克森符号秩检验在所有11个问题中发现，模拟前后问卷显示信心有显著提高（p < 0.019），效应大小（r）范围为0.65至0.9。观察到最高效应大小（r = 0.9）的问题是关于在查房期间开始或停止用药时信心的变化（p = 0.002）。焦点小组讨论的定性分析确定了关键主题，如AR的视觉准确性、交互性需求以及混合方法模拟的认知负荷。
研究结果表明，AR可以通过提供逼真且身临其境的学习体验显著增强医学培训，尽管需要进一步改进以提高交互性并降低认知需求。这项研究突出了整合创新技术以更好地让学生为临床实践做好准备的潜力，并进一步深入了解了在医学教育中使用AR的实际情况。
