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Kitapcioglu D, Aksoy ME, Ozkan AE, Usseli T. Comparing Learning Outcomes of Machine-Guided Virtual Reality-Based Training With Educator-Guided Training in a Metaverse Environment: Randomized Controlled Trial. JMIR Serious Games 2024; 12:e58654. [PMID: 39110497 PMCID: PMC11339586 DOI: 10.2196/58654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/23/2024] [Accepted: 07/06/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Virtual reality (VR) modules are commonly used for health care training, such as adult advanced cardiac life support (ACLS), due to immersion and engagement. The metaverse differs from current VR serious gaming by enabling shared social connections, while current VR modules focus on computer-based content without social interaction. Educators in the metaverse can foster communication and collaboration during training sessions. OBJECTIVE This study aimed to compare learning outcomes of VR-based, machine-guided training with educator-guided, VR-based training in the metaverse environment. METHODS A total of 62 volunteered students from Acibadem Mehmet Ali Aydinlar University Vocational School for Anesthesiology were randomly divided into 2 groups of 31 participants each: one group received VR-based training with machine guidance (MG), and the other received VR-based training with educator guidance (EG) in the metaverse. The members of both groups undertook VR-based basic training for ACLS. Afterward, the MG group was trained with a VR-based advanced training module, which provides training with full MG, whereas the EG group attended the VR-based, educator-guided training in the metaverse. The primary outcome of the study was determined by the exam score of the VR-based training module. Descriptive statistics defined continuous variables such as VR exam scores and time spent on machine- or educator-guided training. The correlation between training time and VR exam scores was assessed with the Spearman rank correlation, and nonnormally distributed variables were compared using the Mann-Whitney U test. Statistical significance was set at P<.05, with analyses executed by MedCalc Statistical Software (version 12.7.7). RESULTS Comparing the VR test scores between the MG and EG groups revealed no statistically significant difference. The VR test scores for the EG group had a median of 86 (range 11-100). In contrast, the MG group scores had a median of 66 (range 13-100; P=.08). Regarding the correlation between the duration of machine-guided or educator-guided training and VR-based exam scores, for the MG group, =0.569 and P=.005 were obtained. For the EG group, this correlation was found to be =0.298 and P=.10. While this correlation is statistically significant for the MG group, it is not significant for the EG group. The post hoc power analysis (80%), considering the correlation between the time spent on training and exam scores, supported this finding. CONCLUSIONS The results of this study suggest that a well-designed, VR-based serious gaming module with MG could provide comparable learning outcomes to VR training in the metaverse with EG for adult ACLS training. Future research with a larger sample size could explore whether social interaction with educators in a metaverse environment offers added benefits for learners. TRIAL REGISTRATION ClinicalTrials.gov NCT06288087; https://clinicaltrials.gov/study/NCT06288087.
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Affiliation(s)
- Dilek Kitapcioglu
- Center of Advanced Simulation and Education (CASE), Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Mehmet Emin Aksoy
- Center of Advanced Simulation and Education (CASE), Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
- Department of Biomedical Device Technology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Arun Ekin Ozkan
- Center of Advanced Simulation and Education (CASE), Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Tuba Usseli
- Vocational School for Anaesthesiology Technicians, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Nasirzade A, Deldar K, Froutan R, Shakeri MT. Comparison of the effects of burn assessment mission game with feedback lecture on nursing students' knowledge and skills in the burn patients' assessment: a randomized clinical trial. BMC Med Inform Decis Mak 2024; 24:157. [PMID: 38840136 PMCID: PMC11154992 DOI: 10.1186/s12911-024-02558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/28/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Learning of burn patient assessment is very important, but heart-breaking for nursing students. This study aimed to compare the effects of feedback lecture method with a serious game (BAM Game) on nursing students' knowledge and skills in the assessment of burn patients. METHOD In this randomized controlled clinical trial, 42 nursing students in their 5th semester at Mashhad University of Medical Sciences School of Nursing and Midwifery, were randomly assigned to intervention (BAM game, available for two weeks) and control (feedback lecture method presented in two 90-minute sessions) groups. Two weeks after the intervention, all students were evaluated for their knowledge (using knowledge assessment test) and skills (using an Objective Structured Clinical Examination). Statistical analysis involved independent t-test, Fisher's exact test, analysis of covariance (ANCOVA), and univariable and multivariable ordinal logistic regression models. RESULTS Following the intervention, the skill scores were 16.4 (SD 2.2) for the intervention group and 11.8 (SD 3.8) for the control group. Similarly, the knowledge scores were 17.4 (SD 2.2) for the intervention group and 14.7 (SD 2.6) for the control group. Both differences were statistically significant (P < .001). These differences remained significant even after adjusting for various factors such as age, gender, marital status, residence, university entrance exam rank, and annual GPA (P < .05). Furthermore, the BAM game group showed significantly higher skills rank than the feedback lecture group across most stations (eight of ten) (P < .05) in the univariable analysis. Multivariable analysis also revealed a significantly higher skills score across most stations even after adjusting for the mentioned factors (P < .05). These results suggest that the BAM game group had higher skills scores over a range of 1.5 to 3.9 compared to the feedback lecture group. CONCLUSIONS This study demonstrated that nursing students who participated in the BAM game group exhibited superior performance in knowledge acquisition and skill development, compared to those in the control group. These results underscore a significant enhancement in educational outcomes for students involved with the BAM game, confirming its utility as a potent and effective pedagogical instrument within the realm of nursing education. TRIAL REGISTRATION Iranian Registry of Clinical Trials: IRCT20220410054483N1, Registration date: 18/04/2022.
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Affiliation(s)
- Amirreza Nasirzade
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kolsoum Deldar
- Department of Information Technology, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Razieh Froutan
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohammad Taghi Shakeri
- Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Hosseinpour A, Nasiri M, Keshmiri F, Arabzadeh T, Sharafi H. Comparison of the effects of apprenticeship training by sandwich feedback and traditional methods on final-semester operating room technology students' perioperative competence and performance: a randomized, controlled trial. BMC MEDICAL EDUCATION 2024; 24:578. [PMID: 38802778 PMCID: PMC11129480 DOI: 10.1186/s12909-024-05598-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Effective feedback is fundamental in clinical education, as it allows trainers to constantly diagnose the trainees' condition, determine their weaknesses, and intervene at proper times. Recently, different feedback-based approaches have been introduced in clinical training; however, the effectiveness of such interventions still needs to be studied extensively, especially in the perioperative field. Therefore, this study sought to compare the effects of apprenticeship training using sandwich feedback and traditional methods on the perioperative competence and performance of Operating Room (OR) technology students. METHODS Thirty final-semester undergraduate OR technology students taking the apprenticeship courses were randomly allocated into experimental (n = 15) and control (n = 15) groups through the stratified randomization approach. The students in the experimental group experienced Feedback-Based Learning (FBL) using a sandwich model, and the students in the control group participated in Traditional-Based Training (TBT) in six five-hour sessions weekly for three consecutive weeks. All students completed the Persian version of the Perceived Perioperative Competence Scale-Revised (PPCS-R) on the first and last days of interventions. Also, a blinded rater completed a checklist to evaluate all students' performance via Direct Observation of Procedural Skills (DOPS) on the last intervention day. Besides, the students in the FBL filled out a questionnaire regarding their attitude toward the implemented program. RESULTS The mean total score of the PPCS-R was significantly higher in the FBL than in the TBT on the last intervention day (P < 0.001). Additionally, the increase in mean change of PPCS-R total score from the first to last days was significantly more in the FBL (P < 0.001). Likewise, the FBL students had higher DOPS scores than the TBT ones (P < 0.001). Most FBL students also had a good attitude toward the implemented program (n = 8; 53.3%). CONCLUSION Apprenticeship training using a sandwich feedback-based approach was superior to the traditional method for enhancing perioperative competence and performance of final-semester OR technology students. Additional studies are required to identify the sustainability of the findings.
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Affiliation(s)
- Azam Hosseinpour
- Department of Operating Room, School of Allied Medical Sciences, Qom University of Medical Sciences, Qom, Iran
| | - Morteza Nasiri
- Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Keshmiri
- Department of Medical Education, Education Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tayebeh Arabzadeh
- Department of Operating Room, Behbahan Faculty of Medical Sciences, P.O. Box 6361796819, Behbahan, Iran.
| | - Hossein Sharafi
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
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Aster A, Laupichler MC, Zimmer S, Raupach T. Game design elements of serious games in the education of medical and healthcare professions: a mixed-methods systematic review of underlying theories and teaching effectiveness. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10327-1. [PMID: 38563873 DOI: 10.1007/s10459-024-10327-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/24/2024] [Indexed: 04/04/2024]
Abstract
Serious games, as a learning resource, enhance their game character by embedding game design elements that are typically used in entertainment games. Serious games in its entirety have already proven their teaching effectiveness in different educational contexts including medical education. The embedded game design elements play an essential role for a game's effectiveness and thus they should be selected based on evidence-based theories. For game design elements embedded in serious games used for the education of medical and healthcare professions, an overview of theories for the selection lacks. Additionally, it is still unclear whether and how single game design elements affect the learning effectiveness. Therefore, the main aim of this systematic review is threefold. Firstly, light will be shed on the single game design elements used in serious games in this area. Second, the game design elements' underlying theories will be worked out, and third, the game design elements' effectiveness on student learning outcome will be assessed. Two literature searches were conducted in November 2021 and May 2022 in six literature databases with keywords covering the fields of educational game design, serious game, and medical education. Out of 1006 initial records, 91 were included after applying predefined exclusion criteria. Data analysis revealed that the three most common game design elements were points, storyline, and feedback. Only four underlying theories were mentioned, and no study evaluated specific game design elements. Since game design elements should be based on theories to ensure meaningful evaluations, the conceptual GATE framework is introduced, which facilitates the selection of evidence-based game design elements for serious games.
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Affiliation(s)
- Alexandra Aster
- Institute of Medical Education, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany.
| | - Matthias Carl Laupichler
- Institute of Medical Education, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany
| | - Saskia Zimmer
- Institute of Medical Education, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany
| | - Tobias Raupach
- Institute of Medical Education, University Hospital Bonn, Venusberg-Campus 1, D-53127, Bonn, Germany
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Delage C, Palayer M, Lerouet D, Besson VC. "Pharmacotrophy": a playful tournament for game- and team-based learning in pharmacology education - assessing its impact on students' performance. BMC MEDICAL EDUCATION 2024; 24:219. [PMID: 38429772 PMCID: PMC10908103 DOI: 10.1186/s12909-024-05157-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND At the Faculty of Pharmacy of Paris, we conducted a pharmacology tournament in 2021 and 2022, named "Pharmacotrophy", to offer a game-, team- and competitive-based learning innovation based on fun and challenge. This article aims to (1) provide a detailed overview of the organisation of "Pharmacotrophy," (2) present and compare feedback from both students and teachers, and (3) assess the impact of student participation on their exam marks. METHODS "Pharmacotrophy" took place in 2021 and 2022 over a two-week period at the beginning of the exam revision phase. It involved a combination of remote matches using the online quiz creation tool Kahoot!® and in-person matches. Teams, consisting of three students from the 4th or 5th year, participated in several selection rounds leading up to the final match. The questions covered various topics from the pharmacology curriculum. Using an anonymous online survey, we collected the feedback from students and teacher regarding the organisation of the tournament and the interest and difficulty of the different type of questions. We retrospectively compared the exam marks of 4th year students who took part in "Pharmacotrophy" (n2021 = 19 and n2022 = 20) with those of the rest of the 4th year (n2021 = 315-320 and n2022 = 279-281), both in the year before "Pharmacotrophy" and just after the tournament. RESULTS Students highlighted the educational benefits of team-based and game-based learning. This novel approach positively and constructively motivated students to review pharmacology. Additionally, students appreciated the establishment of a trust-based relationship with their teachers. All students had a similar pharmacology level based on their exam results in the year before "Pharmacotrophy." After the tournament, participants had marks 20.1% higher in pharmacology questions compared to non-participants (p = 0.02), while they had comparable overall levels, as evidenced by their final grade averages and marks in non-pharmacology questions. Moreover, participants who advanced further in the competition achieved higher marks in pharmacology questions compared to those who were eliminated early in the tournament. CONCLUSION The implementation of "Pharmacotrophy" provided students with an enjoyable way to review pharmacology coursework and revived the interest in pharmacology for some. Specifically, participating in "Pharmacotrophy" led to an increase in pharmacology marks for students who were not among the top performers in the class or did not excel in pharmacology in the previous year. This study quantified the pedagogical value of this innovative curriculum in terms of knowledge acquisition.
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Affiliation(s)
- Clément Delage
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France.
- Service de Pharmacie, AP-HP, Hôpital Lariboisière-Fernand Widal, F-75010, Paris, France.
- Unité Pédagogique de Pharmacologie, Faculté de Pharmacie de Paris, Université Paris Cité, F-75006, Paris, France.
| | - Maeva Palayer
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France
- Unité Pédagogique de Pharmacologie, Faculté de Pharmacie de Paris, Université Paris Cité, F-75006, Paris, France
| | - Dominique Lerouet
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France
- Unité Pédagogique de Pharmacologie, Faculté de Pharmacie de Paris, Université Paris Cité, F-75006, Paris, France
| | - Valérie C Besson
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France
- Unité Pédagogique de Pharmacologie, Faculté de Pharmacie de Paris, Université Paris Cité, F-75006, Paris, France
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Cheng P, Huang Y, Yang P, Wang H, Xu B, Qu C, Zhang H. The Effects of Serious Games on Cardiopulmonary Resuscitation Training and Education: Systematic Review With Meta-Analysis of Randomized Controlled Trials. JMIR Serious Games 2024; 12:e52990. [PMID: 38319697 PMCID: PMC10879970 DOI: 10.2196/52990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/07/2023] [Accepted: 12/30/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Serious games have emerged as an innovative educational strategy with the potential to significantly enhance the quality and effectiveness of cardiopulmonary resuscitation (CPR) training. Despite their promise, there remains a degree of controversy when comparing the advantages of serious games with traditional CPR training methods. This study seeks to provide a comprehensive assessment of the impact of serious games on CPR training and education by systematically analyzing the results of previous research. OBJECTIVE This study aimed to assess the effect of serious games on CPR training and education by summarizing and pooling the results of previous studies. METHODS We conducted a thorough and systematic search across 9 prominent web-based databases, encompassing the period from the inception of these databases until April 1, 2023. The databases included in our search were PubMed, Cochrane Library, Wiley Online Library, EBSCO (PsycInfo), SpringerLink, Chinese Biology Medicine Disc, Vip Journal Integration Platform, Wanfang Database, and Chinese National Knowledge Infrastructure. The studies selected adhered to the following criteria: (1) being a randomized controlled trial comparing serious games and traditional methods for CPR training; (2) having participants aged 12 years or older in CPR; (3) having an experimental group using serious games and a control group using nongame methods for CPR instruction; and (4) having outcomes including theoretical and skill assessments, compression depth, and rate. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias. Data analysis was performed using RevMan (version 5.3; Cochrane Training), and mean differences (MDs) and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. RESULTS A total of 9 articles were included, involving 791 study participants, of whom 395 in the experimental group taught CPR training using serious games and 396 in the control group taught CPR training using traditional methods. The results of our meta-analysis indicate that the use of serious games in CPR training yields outcomes that are comparable in effectiveness to traditional training methods across several key areas. Specifically, serious games demonstrated equivalence to traditional formats in theory assessment (SMD -0.22, 95% CI - 0.96 to 0.51; P=.55), skill assessment (SMD -0.49, 95% CI -1.52 to 0.55; P=.36), compression depth (MD -3.17, 95% CI -0.18 to 6.53; P=.06), and compression rate (MD -0.20, 95% CI -7.29 to 6.89; P=.96). CONCLUSIONS In summary, serious games offer a viable and effective CPR education approach, yielding results comparable to traditional formats. This modality is a valuable addition to CPR training methodologies. However, caution is warranted in interpreting these findings due to limited controlled trials, small sample sizes, and low-quality meta-analyzed evidence.
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Affiliation(s)
- Pengfei Cheng
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yangxi Huang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Pengyu Yang
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Haizhen Wang
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Baichao Xu
- Department of Physical Education, Hainan Medical University, Haikou, China
| | - Chaoran Qu
- Department of the Operating Room, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Hua Zhang
- International Nursing School, Hainan Medical University, Haikou, China
- Key Laboratory of Emergency and Trauma, Ministry of Education, Haikou, China
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Masoumian Hosseini M, Sadat Manzari Z, Gazerani A, Masoumian Hosseini ST, Gazerani A, Rohaninasab M. Can gamified surgical sets improve surgical instrument recognition and student performance retention in the operating room? A multi-institutional experimental crossover study. BMC MEDICAL EDUCATION 2023; 23:907. [PMID: 38031011 PMCID: PMC10688061 DOI: 10.1186/s12909-023-04868-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 11/13/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Surgery requires a high degree of precision, speed, and concentration. Owing to the complexity of the modern world, traditional methods cannot meet these requirements. Therefore, in this study, we investigated students' diagnostic skills in the Operating Room in the context of surgical instruments by using gamification of surgical instruments and a crossover design. METHOD The study design was a multi-institutional quasi-experimental crossover and involved a three-arm intervention (with gender-specific block randomisation: Group A, B, and C) with a pre-test and three post-tests. A total of 90 students fell into three groups of 30 participants each. The surgical sets were learned for one semester through game-based instruction and traditional teaching, and then three OSCE tests were administered with time and location differences. Using one-way ANOVA, OSCE results were compared in the game, traditional, and control groups. The effectiveness of the intervention was tested in each group by repeated measures. RESULT The pretest scores of all three groups did not differ significantly. In the OSCE tests, both groups, A and B, performed similarly. However, these tests showed a significant difference in grouping between training through games and training in the traditional way. There was no significant difference between OSCE tests 2 and 3 in the game-based training group, indicating that what was learned was retained, while in the traditional method training group, OSCE 3 test scores declined significantly. Furthermore, repeated measures showed the effectiveness of game-based training. CONCLUSION In this study, gamification has turned out to be very effective in helping learners learn practical skills and leading to more sustainable learning.
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Affiliation(s)
- Mohsen Masoumian Hosseini
- Department of E-Learning in Medical Science, Tehran University of Medical Sciences, Tehran, Iran
- CyberPatient Research Affiliate, Interactive Health International, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Zahra Sadat Manzari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Azam Gazerani
- Department of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Seyedeh Toktam Masoumian Hosseini
- CyberPatient Research Affiliate, Interactive Health International, Department of Surgery, University of British Columbia, Vancouver, Canada
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Akram Gazerani
- Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mehrdad Rohaninasab
- Department of Operating Room, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Aksoy ME, Özkan AE, Kitapcioglu D, Usseli T. Comparing the Outcomes of Virtual Reality-Based Serious Gaming and Lecture-Based Training for Advanced Life Support Training: Randomized Controlled Trial. JMIR Serious Games 2023; 11:e46964. [PMID: 37768719 PMCID: PMC10570891 DOI: 10.2196/46964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/04/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Simulation-based Advanced Cardiac Life Support (ACLS) or Advanced Life Support (ALS) training for health care professionals is important worldwide for saving lives. Virtual reality (VR)-based serious gaming can be an alternative modality to be used as a part of simulation-based ALS training. OBJECTIVE The aim of this study is to investigate whether a VR-based ALS serious game module can replace classroom-based ALS lectures, the latter being part of existing conventional ALS training protocols in addition to skills training. METHODS Participants were students from Acibadem Mehmet Ali Aydinlar University's Vocational School for Anesthesiology (N=29) randomly divided into 2 groups with 15 (conventional training group) and 14 (VR-based training group) participants each. Participants in the conventional training group had to complete the pretest consisting of multiple-choice questions at the beginning of the study. Afterward, they took part in an interactive classroom-based ALS lecture. The next step involved skills training with task trainers to teach them compression skills. Following this, the conventional training group was divided into Code Blue teams, each consisting of 5 participants for the simulation session. Two independent instructors evaluated video recordings in terms of technical and nontechnical skills. The score acquired from the manikin-based simulation session was considered the main performance indicator in this study to measure the learning outcome. A similar workflow was used for the VR-based training group, but this group was trained with the VR-based ALS serious game module instead of the theoretical lecture. The final stage of the study involved completing the posttest consisting of multiple-choice questions. A preference survey was conducted among the study participants. Mann-Whitney U and Wilcoxon signed-rank tests were used to analyze the 2 groups' performances in this study. RESULTS The improvement in posttest results compared with pretest results was significant in the conventional training group (P=.002). Hands-on technical scores of the conventional training group were higher than those of the VR-based training group during manikin-based simulation, but total scores, including those for technical and crisis resource management skills, acquired from the manikin-based simulation session did not reveal any significant difference between the 2 groups. The results of the VR preference survey revealed that the majority of the participants prefer VR-based serious game-based training instead of classroom lectures. CONCLUSIONS Although hands-on technical scores of the conventional training group during the manikin-based simulation session were higher than those of the VR-based training group, both groups' total performance scores, including those for technical and crisis resource management skills, did not differ significantly. The preference survey reveals that the majority of the participants would prefer a VR-based ALS serious gaming module instead of lecture-based training. Further studies are required to reveal the learning outcome of VR-based ALS serious gaming. TRIAL REGISTRATION ClinicalTrials.gov NCT05798910; https://clinicaltrials.gov/study/NCT05798910.
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Affiliation(s)
- Mehmet Emin Aksoy
- Department of Biomedical Device Technology, Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Arun Ekin Özkan
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Dilek Kitapcioglu
- Department of Medical Education, Medical Faculty, Center of Advanced Simulation and Education, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Tuba Usseli
- Vocational School for Anaesthesiology Technicians, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Khorammakan R, Omid A, Mirmohammadsadeghi M, Ghadami A. Puzzle game-based learning: a new approach to promote learning of principles of coronary artery bypass graft surgery. BMC MEDICAL EDUCATION 2023; 23:241. [PMID: 37055824 PMCID: PMC10100633 DOI: 10.1186/s12909-023-04156-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Since learning with high educational quality requires an advanced intervention. This study seeks to answer how many puzzles game-based training can improve knowledge and cognitive function of surgical technology students in CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation. MATERIALS AND METHODS This study was carried out as a quasi-experimental single-group pre-test-post-test, during which, after designing a puzzle game including various stages of surgery (from the preparation of the patient for surgical sutures and the necessary equipment to perform each stage), 18 people from third-year surgical technology students who met the inclusion criteria were entered in the study by convenience sampling method and based on the sample size determined using a similar study and they participated in the test of knowledge and cognitive function, that the validity and reliability were measured, before the intervention and 14 days after the intervention (using a puzzle game). Data were analyzed using descriptive and Wilcoxon statistical tests. RESULTS After the withdrawal of 2 people, 15 person (93.80 per cent) of the students were female, the average age of students was 21.87 ± 0.71 years, and 50% (8 people) of them were 22 years old. Also, the average score of the end-of-semester exam of the heart surgery technology course was 15.19 ± 2.30 (the lowest score was 11.25, and the highest score was 18.63), and the score of 43.80% (7 people) of them were in the range of 15.01-17.70, and their average of grade point average was 17.31 ± 1.10 (the lowest grade point average is 15 and the highest grade point average is 19.36) and grade point average 75% (11 people) of students were 16-18. The average scores of knowledge(5.75 ± 1.65 vs. 2.68 ± 0.79) and cognitive performance(6.31 ± 2.57 vs. 2.00 ± 1.09) of students in the post-intervention phase were significantly higher than the pre-intervention phase (P < 0.0001). CONCLUSION The results of the present study showed that the use of puzzle games in CABG surgery training led to a significant improvement in the knowledge and cognitive performance of surgical technology students regarding the stages of CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.
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Affiliation(s)
- Reza Khorammakan
- Student research committee, School of nursing and midwifery, Isfahan university of medical sciences, Isfahan, Iran
| | - Athar Omid
- Associate professor, Medical Education Research Center, Department of Medical Education, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ahmad Ghadami
- Department of operating room, Nursing and midwifery research center, School of nursing and midwifery, Isfahan university of medical sciences, Isfahan, Iran.
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