Wang Qianyun, Wang Feifei, Jiang Can, Guo Jun
Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
BMC Med Educ. 2025 Apr 29;25(1):634. doi: 10.1186/s12909-025-07225-4.
Clinical reasoning education is a very systematic and highly logical medical learning process, but the existing teaching models and methods often divide this process into several stages for separate training using a virtual reality (VR)simulator can simulate and reconstruct the cardiac anatomical structure, ultrasonic section operation, and color doppler ultrasound parameter measurement, then integrate it into a single disease or case. In this case, the students' operation skills,decision-making and communication skills were trained by cardiac physical examination, inquiry and interpretation of laboratory examination results. This study aims to investigate whether the application of virtual simulation technology in cardiac ultrasound learning can improve students' thinking ability in the diagnosis and treatment of structural heart diseases.
This study involved fifty-nine undergraduate students studying clinical medicine in the fifth semester at Jinan University. We employed a simple randomization method for random grouping. Random numbers were generated in Excel based on the students' student IDs. Then the students were sorted and divided into the experimental group, which used virtual simulation teaching based on ultrasound, and the control group, which used traditional teaching method. Following the completion of theory teaching, operation demonstration, clinical skills practice and VR practice, students underwent an offline image assessment and online systematic test, which included cardiac ultrasound operation assessment and virtual simulation case assessment to evaluate their proficiency in clinical skills and analytical ability in clinical reasoning. Furthermore, the VR group was given a separate questionnaire to provide their feedback on the cardiac ultrasound virtual simulation education.
There were no statistically significant differences between the two groups in the scores for offline image interpretation and patient inquiry in the virtual simulation case analysis (P > 0.05). The scores for physical examination in virtual simulation case analysis (P < 0.05), virtual simulation ultrasound manipulation(P < 0.05) and diagnosis in virtual simulation case analysis(P < 0.05) were higher in the VR group than in the control group, and the difference was statistically significant. The total score for all evaluation of teaching quality in the VR group was higher than in the control group (P < 0.05). Furthermore, the majorityof students in the VR group displayed satisfaction with course experience, learning effect, teaching evaluation, and overall evaluation.
This research demonstrates that cardiac ultrasound virtual simulation technology could improve students' thinking ability in diagnosing and treating of structural heart diseases. The virtual simulation technology not only could be used for technology imitation but also could leverage its characteristics to demonstrate the process of a certain disease from anatomy to pathophysiology and clinical signs from shallow to deep.
临床推理教育是一个非常系统且逻辑性很强的医学学习过程，但现有的教学模式和方法往往将这个过程分成几个阶段进行单独训练。使用虚拟现实（VR）模拟器可以模拟和重建心脏解剖结构、超声切面操作以及彩色多普勒超声参数测量，然后将其整合到单个疾病或病例中。在这种情况下，通过心脏体格检查、询问和解读实验室检查结果来训练学生的操作技能、决策和沟通技巧。本研究旨在探讨虚拟模拟技术在心脏超声学习中的应用是否能提高学生对结构性心脏病的诊断和治疗思维能力。
本研究纳入了59名暨南大学临床医学专业五年级的本科生。采用简单随机化方法进行随机分组。基于学生的学号在Excel中生成随机数。然后对学生进行排序并分为实验组（采用基于超声的虚拟模拟教学）和对照组（采用传统教学方法）。在完成理论教学、操作演示、临床技能实践和VR实践后，学生进行离线图像评估和在线系统测试，包括心脏超声操作评估和虚拟模拟病例评估，以评估他们的临床技能熟练程度和临床推理分析能力。此外，给VR组发放一份单独的问卷，以获取他们对心脏超声虚拟模拟教育的反馈。
在虚拟模拟病例分析中的离线图像解读和患者询问得分方面，两组之间无统计学显著差异（P>0.05）。VR组在虚拟模拟病例分析中的体格检查得分（P<0.05）、虚拟模拟超声操作得分（P<0.05）和虚拟模拟病例分析中的诊断得分（P<0.05）均高于对照组，差异具有统计学意义。VR组教学质量所有评估的总分高于对照组（P<0.05）。此外，VR组的大多数学生对课程体验、学习效果、教学评价和总体评价表示满意。
本研究表明，心脏超声虚拟模拟技术可以提高学生对结构性心脏病的诊断和治疗思维能力。虚拟模拟技术不仅可用于技术模仿，还可利用其特点从解剖学至病理生理学、从浅至深地展示某种疾病的临床体征过程。
