Exploring the Role of Virtual Reality to Support Clinical Diabetes Training-A Pilot Study

Effectiveness of immersive technologies in oral health promotion and education: A systematic review

OBJECTIVE

To evaluate the effectiveness of immersive technologies in oral health promotion and education.

METHODS

An extensive literature review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method. This study was systematically performed in six electronic databases (PubMed, Google Scholar, Web of Science, Cochrane, Scopus, and EBSCO). The risk of bias was assessed with the Cochrane tools using RoB 2.0 and ROBINS-I.

RESULTS

PICOS criteria were formulated for study inclusion. The bibliographical search identified 10,074 articles, which were filtered subsequently. Finally, the most pertinent nine articles were included and scrutinized for data synthesis and analysis. This includes five randomized controlled trials and four non-randomized controlled trials in different countries that focused on children (33.3%), adolescents (11.1%), and adults (55.6%). The interventions used virtual reality (VR) and augmented reality (AR) to promote knowledge and attitudes towards oral care, improve toothbrushing performance, and smoking cessation, and reduce anxiety levels in oral health education.

CONCLUSION

This systematic review demonstrates that immersive technologies, including VR and AR, significantly enhance oral health knowledge, attitudes, and self-efficacy, leading to improved health outcomes.

CLINICAL SIGNIFICANCE

Immersive technologies such as VR and AR have the potential to provide innovative and effective methods for enhancing oral health promotion and education, while promoting positive health behaviours, which are crucial for improving overall oral health outcomes.

The impact of simulation-based training in medical education: A review

Simulation-based training (SBT) has emerged as a transformative approach in medical education, significantly enhancing healthcare professionals' learning experience and clinical competency. This article explores the impact of SBT, tracing its historical development and examining the various types of simulations utilized today, including high-fidelity mannequins, virtual reality environments, standardized patients, and hybrid simulations. These methods offer a safe and controlled environment for students to practice and hone technical and non-technical skills, ultimately improving patient safety and clinical outcomes. The benefits of SBT are manifold, including enhanced skill acquisition, error reduction, and the opportunity for repeated practice without risk to actual patients. Immediate feedback and structured debriefing further solidify learning, making Simulation an invaluable tool in medical education. However, the implementation of SBT is challenging. It requires substantial financial investment, specialized equipment, and trained faculty. Additionally, there are concerns about the realism of simulations and the transferability of skills to real-world clinical settings. Despite these challenges, numerous case studies and empirical research underscore the effectiveness of SBT compared to traditional methods. Looking ahead, advancements in technology, such as artificial intelligence and improved virtual reality applications, promise to enhance the efficacy and accessibility of simulation training. The integration of Simulation with other training modalities and its adoption in diverse global contexts highlight its potential to revolutionize medical education worldwide. This article affirms the crucial role of SBT in preparing the next generation of healthcare professionals and its ongoing evolution driven by technological innovations.

Exploring extended reality for diabetes education & self-management - A bibliometric analysis from 1999 to 2023

BACKGROUND

Diabetes Mellitus (DM) has emerged as a rapidly growing non-communicable disease (NCD) across developed & developing countries. People with diabetes mellitus experience health implications. They develop associated microvascular complications such as neuropathy, nephropathy & retinopathy and macro-vascular complications like coronary artery disease, stroke, amputations etc. These complications increase the socio-economic burden of people living with diabetes. Self-management of diabetes through education is a strong tool that remains under-utilized in clinical settings. The objective of the present study was to explore the role of extended reality for diabetes education & self-management.

METHODOLOGY

The present study is a bibliometric analysis performed on the Scopus database with keywords: diabetes education, self-management, extended reality, virtual reality, augmented reality, mixed reality, and Boolean operators AND, OR. The search period ranged from inception till 4th July 2023 with restriction to English language articles. A total of 89 documents were identified in Scopus under multiple domains such as Engineering, Medicine, Health Professions, Nursing among others. The data was exported to the VOS Viewer software for network analysis.

RESULTS

Out of the total 89 documents, 45-original research, 26-review, 12-conference paper, 3-book, 2-book chapters & 1-note. The highest publications were from the Medicine category. The year of publication of the included documents ranged from 1999 till 2022. The network analysis was performed to explore the association between the included studies (co-authorship, co-occurrence, citation analysis, bibliographic coupling).

CONCLUSION

The network analysis found the USA to be the leading publisher and the National Institute of Health (NIH) to be the leading funding source. There is limited evidence and a strong future scope to strengthen research productivity on extended reality for diabetes education & self-management.

Virtual Reality Meets Diabetes

BACKGROUND

This article provides a detailed summary of virtual reality (VR) and augmented reality (AR) applications in diabetes. The purpose of this comparative review is to identify application areas, direction and provide foundation for future virtual reality tools in diabetes.

METHOD

Features and benefits of each VR diabetes application are compared and discussed, following a thorough review of literature on virtual reality for diabetes using multiple databases. The weaknesses of existing VR applications are discussed and their strengths identified so that these can be carried forward. A novel virtual reality diabetes tool prototype is also developed and presented.

RESULTS

This research identifies three major categories where VR is being used in diabetes: education, prevention and treatment. Within diabetes education, there are three target groups: clinicians, adults with diabetes and children with diabetes. Both VR and AR have shown benefits in areas of Type 1 and Type 2 diabetes.

CONCLUSIONS

Virtual reality and augmented reality in diabetes have demonstrated potential to enhance training of diabetologists and enhance education, prevention and treatment for adults and children with Type 1 or Type 2 diabetes. Future research can continually build on virtual and augmented reality diabetes applications by integrating wide stakeholder inputs and diverse digital platforms. Several areas of VR diabetes are in early stages, with advantages and opportunities. Further VR diabetes innovations are encouraging to enhance training, management and treatment of diabetes.

United Kingdom medical student expansion - Can new medical schools seize the initiative?

In June 2023, National Health Service (NHS) England published a Long-Term Workforce Plan 'to put staffing on a sustainable footing and improve patient care.' The plan falls in to three main areas: train, retain and reform. Currently there are around 7,500 medical school places available annually in England, but it is proposed to increase this to 10,000 by 2028 and to 15,000 by 2031. Five new medical schools were approved in the 2018 expansion and others are preparing applications in anticipation of future expansion. In this article, we discuss what factors might shape a new medical school, ensuring it meets the standards required by the UK regulator (General Medical Council) set out in Promoting Excellence and in Outcomes for Graduates.

Design and Usability of an Avatar-Based Learning Program to Support Diabetes Education: Quality Improvement Study in Colombia

BACKGROUND

This quality improvement study, entitled Avatar-Based LEarning for Diabetes Optimal Control (ABLEDOC), explored the feasibility of delivering an educational program to people with diabetes in Colombia. The aim was to discover how this approach could be used to improve awareness and understanding of the condition, the effects of treatment, and strategies for effective management of blood-glucose control.

METHODS

Individuals with diabetes were recruited by Colombian endocrinologists to a human-centered study to codesign the educational program, using the Double Diamond model. Participants contributed to two phases. The first phase focused on gathering unmet educational needs and choice of curriculum. Three prototypes were developed as a result. During phase 2, a different group of participants engaged with the program for several weeks, before reporting back.

RESULTS

Thirty-six participants completed a Web survey during phase 1, and five were also interviewed by telephone. The majority (33 of 36; 91%) were receptive to the prospect of educational interventions and ranked the chosen topic of hypoglycemia highly. In phase 2, the three prototypes were tested by 17 participants, 10 of whom also gave feedback in focus groups. The response was overwhelmingly positive, with 16 of 17 (94%) stating they would use a program like this again. The 3D version was the most highly rated.

CONCLUSIONS

Immersive, avatar-based programs, delivered through smartphone, have the potential to deliver educational information that is trusted, engaging, and useful. Future work includes expansion of the curriculum, evaluation with a larger group, and exploration of the prospective role of artificial intelligence in personalizing this form of educational intervention.

Under- and post-graduate training to manage the acutely unwell patient: a scoping review

BACKGROUND

Junior doctors are often the first responders to acutely unwell patients and yet frequently report feeling under-prepared to do so. To understand whether this is consequential of how medical students and doctors are trained to manage acutely unwell patients, a scoping review was conducted using a systematic approach.

METHODS

The review, informed by the Arksey and O'Malley and PRISMA-ScR guidelines, identified educational interventions targeting the management of acutely unwell adults. Seven major literature databases were searched for journal articles published in English from 2005 to 2022, in addition to the Association of Medical Education in Europe (AMEE) conference proceedings from 2014 to 2022.

RESULTS

Seventy-three articles and abstracts were eligible for the review, the majority of which were from the UK or USA, and demonstrated that educational interventions were more commonly targeted at medical students than qualified doctors. The majority of studies used simulation, but very few integrated complexities of the clinical environment within scenarios such as multidisciplinary working, distraction-handling techniques and other non-technical skills. A wide range of learning objectives pertaining to acute patient management were stated across studies, but few explicitly cited educational theory underpinning their study.

CONCLUSIONS

The results of this review encourages future educational initiatives to consider enhancing authenticity within simulation to promote transfer of learning to clinical practice, and use educational theory to augment the sharing of educational approaches within the community of clinical education practice. Additionally, increasing the focus on post-graduate learning, building upon undergraduate educational foundations, is essential to promoting lifelong learning within the ever-changing healthcare environment.

A scoping review to assess the effects of virtual reality in medical education and clinical care

Due to the challenges and restrictions posed by COVID-19 pandemic, technology and digital solutions played an important role in the rendering of necessary healthcare services, notably in medical education and clinical care. The aim of this scoping review was to analyze and sum up the most recent developments in Virtual Reality (VR) use for therapeutic care and medical education, with a focus on training medical students and patients. We identified 3743 studies, of which 28 were ultimately selected for the review. The search strategy followed the most recent Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping review (PRISMA-ScR) guidelines. 11 studies (39.3%) in the field of medical education assessed different domains, such as knowledge, skills, attitudes, confidence, self-efficacy, and empathy. 17 studies (60.7%) focused on clinical care, particularly in the areas of mental health, and rehabilitation. Among these, 13 studies also investigated user experiences and feasibility in addition to clinical outcomes. Overall, the findings of our review reported considerable improvements in terms of medical education and clinical care. VR systems were also found to be safe, engaging, and beneficial by the studies' participants. There were huge variations in studies with respect to the study designs, VR contents, devices, evaluation methods, and treatment periods. In the future, studies may focus on creating definitive guidelines that can help in improving patient care further. Hence, there is an urgent need for researchers to collaborate with the VR industry and healthcare professionals to foster a better understanding of contents and simulation development.