Favier Amelia, Jaafar Eya, L'Hote Raphael, Gauthier Philippe, Avellino Ignacio, Canlorbe Geoffroy
Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospital, Paris, France.
Sorbonne Université, Inserm, UMR 938, Centre de Recherche Saint Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France.
Int J Surg. 2024 Dec 1;110(12):7832-7839. doi: 10.1097/JS9.0000000000002146.
Unlike other medical specialties, surgery is primarily learned through apprenticeship, by observing surgeons in action during operations. However, the increasing number of medical students and work-hour restrictions limit opportunities for learning in the operating room (OR). These circumstances call for novel technologies, such as immersive video. The objective of this study is to compare knowledge retention, preparedness, and content engagement for surgical learning when watching a surgical video in 3D through a Head-Mounted Display (HMD) versus in 2D video on a conventional screen.
This randomized controlled trial includes 231 fourth-year medical students. Participants watched the same 12 min surgical video, narrated by an expert, presented either in immersive 3D form through an HMD, or in 2D form through a conventional screen. The students completed three questionnaires (previewing, postviewing, and 1 month later), which included questions on knowledge retention, expected preparedness, content engagement, tool engagement, and self-assessment. Statistical analyses were adjusted by including the confounding factors.
Immediately after the video, the 3D immersive video group showed a significantly lower knowledge retention score compared to the classic video group (P<0.01). Nonetheless, the 3D immersive video group demonstrated better-expected preparedness as a future resident (P=0.019), greater satisfaction (P=0.033), better stimulation (P<0.001), higher involvement (P<0.001), and a greater perceived ability to identify anatomical structures (P<0.001). After 1 month, participants in the immersive video group reported feeling more prepared (P=0.016), more self-confident (P=0.020), more at ease (P=0.023), and less overwhelmed (P<0.01) than those in the 2D video group.
Our results showed that 3D surgical immersive video vs. 2D surgical video, enhances the sense of stimulation, satisfaction, involvement, and the perception of having better identified anatomical structures. For early medical school students where access to the OR is limited, this tool appears to a significant step forward in surgical pedagogy. However, the precise understanding of its pedagogical value required further investigation and refinement.
与其他医学专业不同，外科手术主要是通过学徒制学习，即通过在手术过程中观察外科医生的操作来学习。然而，医学生数量的增加和工作时间限制减少了在手术室（OR）学习的机会。这些情况需要新技术，如沉浸式视频。本研究的目的是比较通过头戴式显示器（HMD）观看3D手术视频与在传统屏幕上观看2D视频时，外科学习的知识保留、准备情况和内容参与度。
这项随机对照试验纳入了231名四年级医学生。参与者观看了由专家讲解的相同12分钟手术视频，视频以沉浸式3D形式通过HMD呈现，或以2D形式通过传统屏幕呈现。学生们完成了三份问卷（预习、观看后和1个月后），问卷包括关于知识保留、预期准备情况、内容参与度、工具参与度和自我评估的问题。统计分析纳入了混杂因素进行调整。
视频观看后立即进行评估，3D沉浸式视频组的知识保留得分显著低于经典视频组（P<0.01）。尽管如此，3D沉浸式视频组作为未来住院医师表现出更好的预期准备情况（P=0.019）、更高的满意度（P=0.033）、更好的刺激感（P<0.001）、更高的参与度（P<0.001）以及更强的识别解剖结构的感知能力（P<0.001）。1个月后，沉浸式视频组的参与者报告称，与2D视频组的参与者相比，他们感觉准备更充分（P=0.016）、更自信（P=0.020）、更轻松（P=0.023）且压力更小（P<0.01）。
我们的结果表明，与2D手术视频相比，3D手术沉浸式视频增强了刺激感、满意度、参与度以及对更好地识别解剖结构的感知。对于早期医学生，在进入手术室受限的情况下，这种工具似乎是外科教学的一大进步。然而，对其教学价值的精确理解还需要进一步研究和完善。
