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Würstle S, Spanke LM, Mehlhase N, Stanley G, Koff J, Dimitriadis S, König S, Hann A. Evaluation of a Virtual Reality-Based Open Educational Resource Software. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241242220. [PMID: 38572090 PMCID: PMC10989036 DOI: 10.1177/23821205241242220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/28/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Virtual reality (VR) teaching methods have potential to support medical students acquire increasing amounts of knowledge. EVENT (Easy VR EducatioN Tool) is an open educational resource software for immersive VR environments, which is designed for use without programming skills. In this work, EVENT was used in a medical student VR course on pancreatic cancer. METHODS Medical students were invited to participate in the course. Before and after VR simulation, participants completed a multiple-choice knowledge assessment, with a maximum score of 10, and a VR experience questionnaire. The primary endpoint compared pre- and post-VR simulation test scores. Secondary endpoints included usability and factors that could affect learning growth and test results. RESULTS Data from 117 of the 135 participating students was available for analysis. Student test scores improved by an average of 3.4 points (95% CI 3.1-3.7, P < 0.001) after VR course. The secondary endpoints of gender, age, prior knowledge regarding the medical subject, professional training completed in the medical field, video game play, three-dimensional imagination skills, or cyber-sickness had no major impact on test scores or final ranking (top or bottom 25%). The 27 students whose post-VR simulation test scores ranked in the top 25% had no prior experience with VR. The average System Usability Scale score was 86.1, which corresponds to an excellent outcome for user-friendliness. Questionnaire responses post-VR simulation show students (81.2% [95/117]) interest in more VR options in medical school. CONCLUSIONS We present a freely available software that allows for the development of VR teaching lessons without programming skills.
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Affiliation(s)
- Silvia Würstle
- Department of Internal Medicine II, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
- Department of Internal Medicine II, University Hospital rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lisa-Marie Spanke
- Interventional and Experimental Endoscopy (InExEn), Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
- Institute of Medical Teaching and Medical Education Research, University Hospital Würzburg, Würzburg, Germany
| | - Niklas Mehlhase
- Interventional and Experimental Endoscopy (InExEn), Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
| | - Gail Stanley
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Jonathan Koff
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Stavros Dimitriadis
- Department of Gastroenterology, University Hospital Coventry and Warwickshire, Coventry, CV2 2DX, UK
| | - Sarah König
- Institute of Medical Teaching and Medical Education Research, University Hospital Würzburg, Würzburg, Germany
| | - Alexander Hann
- Interventional and Experimental Endoscopy (InExEn), Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
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Gruss S, Schmid M, Walter S, Schick B, Holler L, Barth E. The impact of analgesic on EMG and other biosignals in a postoperative setting. Front Med (Lausanne) 2023; 10:1038154. [PMID: 37007775 PMCID: PMC10050344 DOI: 10.3389/fmed.2023.1038154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundIn the clinical context, the assessment of pain in patients with inadequate communication skills is standardly performed externally by trained medical staff. Automated pain recognition (APR) could make a significant contribution here. Hereby, pain responses are captured using mainly video cams and biosignal sensors. Primary, the automated monitoring of pain during the onset of analgesic sedation has the highest relevance in intensive care medicine. In this context, facial electromyography (EMG) represents an alternative to recording facial expressions via video in terms of data security. In the present study, specific physiological signals were analyzed to determine, whether a distinction can be made between pre-and post-analgesic administration in a postoperative setting. Explicitly, the significance of the facial EMG regarding the operationalization of the effect of analgesia was tested.MethodsN = 38 patients scheduled for surgical intervention where prospectively recruited. After the procedure the patients were transferred to intermediate care. Biosignals were recorded and all doses of analgesic sedations were carefully documented until they were transferred back to the general ward.ResultsAlmost every biosignal feature is able to distinguish significantly between ‘before’ and ‘after’ pain medication. We found the highest effect sizes (r = 0.56) for the facial EMG.ConclusionThe results of the present study, findings from research based on the BioVid and X-ITE pain datasets, staff and patient acceptance indicate that it would now be appropriate to develop an APR prototype.
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Affiliation(s)
- Sascha Gruss
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Ulm, Ulm, Germany
- *Correspondence: Sascha Gruss,
| | - Matthias Schmid
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Ulm, Ulm, Germany
| | - Steffen Walter
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Ulm, Ulm, Germany
| | - Benedikt Schick
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Ulm, Ulm, Germany
| | - Lena Holler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Ulm, Ulm, Germany
| | - Eberhard Barth
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Ulm, Ulm, Germany
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Chen G, Zhao Y, Xie F, Shi W, Yang Y, Yang A, Wu D. Educating Outpatients for Bowel Preparation Before Colonoscopy Using Conventional Methods vs Virtual Reality Videos Plus Conventional Methods: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2135576. [PMID: 34807255 PMCID: PMC8609410 DOI: 10.1001/jamanetworkopen.2021.35576] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Adequate bowel preparation is essential for diagnostic, screening, and surveillance colonoscopy. Virtual reality (VR) has the characteristics of immersion, interaction, and imagination and has been widely used in medicine for training and teaching, indicating that it could be used in the education of outpatients for bowel preparation before colonoscopy. OBJECTIVE To investigate whether using VR videos for patient education before colonoscopy could improve bowel preparation. DESIGN, SETTING, AND PARTICIPANTS A prospective, single-blinded, randomized clinical trial of 346 patients undergoing colonoscopy with local anesthesia in a tertiary care hospital was conducted between October 1, 2018, and November 1, 2020. Outpatients who had indications for colonoscopy and had not received one before were enrolled. Statistical analysis was performed from November 1 to December 31, 2020. All data were analyzed according to the intention-to-treat approach. EXPOSURES Conventional bowel preparation education (oral instructions and written materials that had the same contents) or conventional education plus VR videos. MAIN OUTCOMES AND MEASURES The primary outcome was the quality of bowel preparation measured by the Boston Bowel Preparation Scale score (range, 0-9, where 0 indicates extremely unsatisfactory bowel preparation and 9 indicates complete bowel preparation). Secondary outcomes included polyp and adenoma detection rates, compliance with complete bowel cleansing, preprocedure anxiety, overall satisfaction, and willingness to undergo a follow-up colonoscopy. RESULTS A total of 346 outpatients were enrolled in the trial, with 173 patients randomly assigned to each group (control group: 87 women [50.3%]; mean [SD] age, 50.5 [12.5] years; VR video group: 84 women [48.6%]; mean [SD] age, 52.6 [11.4] years). Baseline characteristics, including demographic information, medical history, lifestyle, and the characteristics of stool, were comparable between the VR video group and the control group. The mean (SD) Boston Bowel Preparation Scale score was significantly higher in the VR video group than in the control group (7.61 [1.65] vs 7.04 [1.70]; P = .002). The detection rate of polyps (72 of 172 [41.9%] vs 46 of 172 [26.7%]; P = .003) and the detection rate of adenomas (56 of 172 [32.6%] vs 38 of 172 [22.1%]; P = .03) were also higher in the VR video group. Patients who received VR education had better compliance (119 [68.8%] vs 87 [50.3%]; P < .001) and higher mean (SD) overall satisfaction (8.68 [1.70] vs 8.16 [2.15]; P = .01) with bowel preparation. CONCLUSIONS AND RELEVANCE Patients who received VR video education before colonoscopy had better bowel preparation, higher polyp and adenoma detection rates, and improved compliance and satisfaction. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03667911.
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Affiliation(s)
- Guorong Chen
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Zhao
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital, Beijing, China
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada
| | - Wen Shi
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yingyun Yang
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Aiming Yang
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Dong Wu
- Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Ligon BL, Burns A, Thammasitboon S. Creating a 'Community of Inquiry': A Framework for Optimizing the Virtual Education Experience. MEDEDPUBLISH 2021; 10:71. [PMID: 38486560 PMCID: PMC10939631 DOI: 10.15694/mep.2021.000071.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: Medical educators must learn to implement technologic advances to create meaningful learning experiences, implementing media tools that are effective in meeting evolving academic needs and fostering interpersonal engagement. The increasing time constraints in a department of more than 1,600 faculty interspersed throughout a large metropolitan complex served as the catalyst for utilizing technology to create a framework for providing virtual faculty development. Objective: To use a Community of Inquiry (CoI) as a framework to guide the development of an interactive, virtual writing retreat. Methods: We used the three elements of CoI--social presence, cognitive presence, and teaching presence--to transform the curriculum and delivery method of an existing writing workshop into an interactive virtual experience. To enhance virtual teaching and learning, we created a positive climate allowing learners to project themselves into the community through discourse (social), leveraged technologies to enable construction of knowledge by individual learners (cognitive), and revamped the existing curriculum for optimal virtual learning outcomes (teaching). We evaluated its educational effectiveness via surveys based on the CoI framework. Results: The highly interactive, four-hour, virtual writing retreat was well received and serves as a model for implementing the CoI framework in other disciplines. Forty multidisciplinary faculty attended the retreat; 90% completed the entire session. In the post-session survey (50% response rate), participants rated the learning activities highly. Conclusion: Our conceptual model and practical recommendations are offered to other medical educators and faculty developers for designing a tailored CoI with effective virtual synchronous learning.
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Hwang JH, Jamidar P, Kyanam Kabir Baig KR, Leung FW, Lightdale JR, Maranki JL, Okolo PI, Swanstrom LL, Chak A. GIE Editorial Board top 10 topics: advances in GI endoscopy in 2019. Gastrointest Endosc 2020; 92:241-251. [PMID: 32470427 DOI: 10.1016/j.gie.2020.05.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023]
Abstract
The American Society for Gastrointestinal Endoscopy's GIE Editorial Board reviewed original endoscopy-related articles published during 2019 in Gastrointestinal Endoscopy and 10 other leading medical and gastroenterology journals. Votes from each individual member were tallied to identify a consensus list of 10 topic areas of major advances in GI endoscopy. Individual board members summarized important findings published in these 10 areas of disinfection, artificial intelligence, bariatric endoscopy, adenoma detection, polypectomy, novel imaging, Barrett's esophagus, third space endoscopy, interventional EUS, and training. This document summarizes these "top 10" endoscopic advances of 2019.
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Affiliation(s)
- Joo Ha Hwang
- Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, California
| | - Priya Jamidar
- Professor of Medicine, Yale University, New Haven, Connecticut
| | | | - Felix W Leung
- Veterans Affairs Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA
| | - Jennifer R Lightdale
- University of Massachusetts Medical School, Umass Memorial Childrens Medical Center, Worcester, Massachusetts
| | | | - Patrick I Okolo
- Executive Medical Director, Rochester Regional Health Systems, Rochester, NY
| | - Lee L Swanstrom
- Professor of Surgery, Oregon Health and Sciences University: Scientific Director and Chief Innovations Officer, Institutes Hospitalos Universitaires (IHU-Strasbourg) University of Strasbourg
| | - Amitabh Chak
- University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Mirhosseini S, Gutenko I, Ojal S, Marino J, Kaufman A. Immersive Virtual Colonoscopy. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2019; 25:2011-2021. [PMID: 30762554 DOI: 10.1109/tvcg.2019.2898763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Virtual colonoscopy (VC) is a non-invasive screening tool for colorectal polyps which employs volume visualization of a colon model reconstructed from a CT scan of the patient's abdomen. We present an immersive analytics system for VC which enhances and improves the traditional desktop VC through the use of VR technologies. Our system, using a head-mounted display (HMD), includes all of the standard VC features, such as the volume rendered endoluminal fly-through, measurement tool, bookmark modes, electronic biopsy, and slice views. The use of VR immersion, stereo, and wider field of view and field of regard has a positive effect on polyp search and analysis tasks in our immersive VC system, a volumetric-based immersive analytics application. Navigation includes enhanced automatic speed and direction controls, based on the user's head orientation, in conjunction with physical navigation for exploration of local proximity. In order to accommodate the resolution and frame rate requirements for HMDs, new rendering techniques have been developed, including mesh-assisted volume raycasting and a novel lighting paradigm. Feedback and further suggestions from expert radiologists show the promise of our system for immersive analysis for VC and encourage new avenues for exploring the use of VR in visualization systems for medical diagnosis.
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Abstract
It is essential to maintain high-quality endoscopy given the increasing number of endoscopic screens performed in Korea. The training of fellows to perform endoscopies is challenging. The rapid development of endoscopic techniques and rising patient complexity increase the training pressures. At the end of training, all practitioners must perform endoscopy safely and effectively. Here, we examine the current status of endoscopy training in Korea. Although our system produces many competent endoscopists, there is room for improvement. Formal training programs should be developed to train the trainers. Specific assessment tools measuring performance and improving training are required. Changes should be made at all levels to improve our endoscopy training system.
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Affiliation(s)
- Joon Sung Kim
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Byung-Wook Kim
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
- Correspondence to Byung-Wook Kim, M.D. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon 21431, Korea Tel.: +82-32-280-5051 Fax: +82-32-280-5082 E-mail:
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