Shilling Valerie, Starkings Rachel, Fallowfield Lesley
SHORE-C, Brighton and Sussex Medical School, Brighton and Hove, England.
BMC Med Educ. 2025 Feb 1;25(1):167. doi: 10.1186/s12909-025-06726-6.
The use of technology in medical education has been increasing with more students exposed to some form of online learning or tutorials, under the umbrella of virtual learning (VL). Many programmes, particularly those involving virtual reality, have centred on practical skills, such as surgical techniques or anatomical knowledge, rather than communication. The study presented here examined the feasibility and acceptability of a VL module developed to aid communication when handling angry patients and their relatives.
Participants were 4th and 5th year medical students at the Brighton and Sussex Medical School. Students were randomly allocated to receive training about having angry conversations in a clinical setting via virtual reality headset or desktop application. Prior to the intervention, everyone completed the SE12 self-efficacy questionnaire, a 5-item confidence measure, and free-response study specific survey. Following the module, they completed another study specific survey, with fixed and free responses, the confidence measure, along with the UTAUT2 questionnaire on acceptance and use of technology. Quantitative data was analysed descriptively, conceptual content analysis was applied to free responses. Participants received a £25 voucher for their time.
Twenty students took part in the project. Scores on the SE12 did not differ significantly between intervention arms. Confidence improved across all five categories - recognising responses that diffuse or exacerbate anger, identifying anger signals, remaining calm in hostile situations, moving forward with empathy, and applying techniques to different situations. Responses to the UTAUT2 indicated acceptance of VL, including the psychological safety it provides. Nineteen categories for free text responses were developed via content analysis. Participants spoke frequently about the challenges of navigating anger. There was initial apprehension VL would not feel realistic, though this was largely reversed post-intervention. Students expressed preference for a combination of VL, whichever modality, and face-to-face teaching, recognising benefits of both.
Students found the training to be acceptable, providing them with tangible skills. There should be a consideration as to how to incorporate VL, with a mix of face-to-face practice for added realism.
Clinical trial number not applicable.
随着越来越多的学生在虚拟学习（VL）的框架下接触到某种形式的在线学习或教程，技术在医学教育中的应用不断增加。许多项目，特别是那些涉及虚拟现实的项目，都集中在实践技能上，如手术技术或解剖学知识，而非沟通能力。本文介绍的这项研究调查了一个为帮助处理愤怒患者及其亲属时的沟通而开发的VL模块的可行性和可接受性。
参与者为布莱顿和苏塞克斯医学院的四年级和五年级医学生。学生们被随机分配，通过虚拟现实头戴设备或桌面应用程序接受在临床环境中进行愤怒对话的培训。在干预前，每个人都完成了SE12自我效能问卷（一项5项的信心测量）和自由回答的特定研究调查。在模块结束后，他们完成了另一项特定研究调查，包括固定回答和自由回答、信心测量，以及关于技术接受和使用的UTAUT2问卷。定量数据进行描述性分析，对自由回答应用概念性内容分析。参与者因参与研究获得了一张25英镑的代金券。
20名学生参与了该项目。干预组之间SE12的得分没有显著差异。所有五个类别（识别化解或加剧愤怒的反应、识别愤怒信号、在敌对情况下保持冷静、以同理心推进以及将技巧应用于不同情况）的信心都有所提高。对UTAUT2的回答表明对VL的接受，包括它提供的心理安全感。通过内容分析得出了19个自由文本回答类别。参与者频繁谈到应对愤怒的挑战。最初有人担心VL不会让人感觉真实，不过这种情况在干预后基本得到扭转。学生们表示倾向于将VL（无论哪种形式）与面对面教学相结合，认识到两者的好处。
学生们认为该培训是可接受的，并为他们提供了切实的技能。应该考虑如何将VL与面对面实践相结合，以增加真实感。
不适用临床试验编号。
