1
|
Salimi S, Asgari Z, Mohammadnejad A, Teimazi A, Bakhtiari M. Efficacy of virtual reality and augmented reality in anatomy education: A systematic review and meta-analysis. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 39300601 DOI: 10.1002/ase.2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 09/22/2024]
Abstract
Anatomy is the cornerstone of medical education. Virtual reality (VR) and augmented reality (AR) technologies are becoming increasingly popular in the development of anatomy education. Various studies have evaluated VR and AR in anatomy education. This meta-analysis aims to evaluate the effectiveness of VR and AR in anatomical education. The protocol was registered in Prospero. Scopus, PubMed, Web of Science, and Cochrane Library databases were searched. From the 4487 articles gathered, 24 randomized controlled trials were finally selected according to inclusion criteria. According to the results of the meta-analysis, VR had a moderate and significant effect on the improvement of knowledge scores in comparison with other methods (standardized mean difference = 0.58; 95% CI = 0.22, 0.95; p < 0.01). Due to the high degree of heterogeneity (I2 = 87.44%), subgroup analyses and meta-regression were performed on eight variables. In enhancing the "attitude," VR was found to be more "useful" than other methods (p = 0.01); however, no significant difference was found for "enjoyable" and "easy to use" statements. Compared with other methods, the effect of AR on knowledge scores was non-significant (SMD = -0.02; 95% CI = -0.39, 0.34; p = 0.90); also, in subgroup analyses and meta-regression, the results were non-significant. The results indicate that, unlike AR, VR could be used as an effective tool for teaching anatomy in medical education. Given the observed heterogeneity across the included studies, further research is warranted to identify those variables that may impact the efficacy of VR and AR in anatomy education.
Collapse
Affiliation(s)
- Sajjad Salimi
- Student Research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Asgari
- Student Research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amirreza Mohammadnejad
- Student Research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ashkan Teimazi
- Student Research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Bakhtiari
- Department of Anatomical Sciences, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
2
|
Truckenmueller P, Krantchev K, Rubarth K, Früh A, Mertens R, Bruening D, Stein C, Vajkoczy P, Picht T, Acker G. Augmented 360° Three-Dimensional Virtual Reality for Enhanced Student Training and Education in Neurosurgery. World Neurosurg 2024; 186:e35-e47. [PMID: 38272307 DOI: 10.1016/j.wneu.2024.01.092] [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: 09/18/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE This prospective study assesses the acceptance and usefulness of augmented 360° virtual reality (VR) videos for early student education and preparation in the field of neurosurgery. METHODS Thirty-five third-year medical students participated. Augmented 360° VR videos depicting three neurosurgical procedures (lumbar discectomy, brain metastasis resection, clipping of an aneurysm) were presented during elective seminars. Multiple questionnaires were employed to evaluate conceptual and technical aspects of the videos. The analysis utilized ordinal logistic regression to identify crucial factors contributing to the learning experience of the videos. RESULTS The videos were consistently rated as good to very good in quality, providing detailed demonstrations of intraoperative anatomy and surgical workflow. Students found the videos highly useful for their learning and preparation for surgical placements, and they strongly supported the establishment of a VR lounge for additional self-directed learning. Notably, 81% reported an increased interest in neurosurgery, and 47% acknowledged the potential influence of the videos on their future choice of specialization. Factors associated with a positive impact on students' interest and learning experience included high technical quality and comprehensive explanations of the surgical steps. CONCLUSIONS This study demonstrated the high acceptance of augmented 360° VR videos as a valuable tool for early student education in neurosurgery. While hands-on training remains indispensable, these videos promote conceptual knowledge, ignite interest in neurosurgery, and provide a much-needed orientation within the operating room. The incorporation of detailed explanations throughout the surgeries with augmentation using superimposed elements, offers distinct advantages over simply observing live surgeries.
Collapse
Affiliation(s)
- Peter Truckenmueller
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurosurgery, Charitéplatz 1, 10117 Berlin, Germany
| | - Kiril Krantchev
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurosurgery, Charitéplatz 1, 10117 Berlin, Germany
| | - Kerstin Rubarth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Informatics, Invalidenstrasse 90, 10115 Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117 Berlin, Germany
| | - Anton Früh
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurosurgery, Charitéplatz 1, 10117 Berlin, Germany; Berlin Institue of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Junior Digital Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany
| | - Robert Mertens
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurosurgery, Charitéplatz 1, 10117 Berlin, Germany; Berlin Institute of Health at Charité - Univsersitätsmedizin Berlin, BIH Academy, Junior Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany
| | - Daniel Bruening
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurosurgery, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian Stein
- Humboldt-Universität zu Berlin, Cluster of Excellence: "Matters of Activity. Image Space Material", Unter den Linden 6, 10099 Berlin, Germany; Humboldt-Universität zu Berlin, gamelab.berlin, Cluster of Excellence: "Matters of Activity. Image Space Material", Unter den Linden 6, 10099 Berlin, Germany
| | - Peter Vajkoczy
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurosurgery, Charitéplatz 1, 10117 Berlin, Germany
| | - Thomas Picht
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurosurgery, Charitéplatz 1, 10117 Berlin, Germany; Humboldt-Universität zu Berlin, Cluster of Excellence: "Matters of Activity. Image Space Material", Unter den Linden 6, 10099 Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Simulation and Training Center (BeST), Charitéplatz 1, 10117 Berlin, Germany
| | - Gueliz Acker
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurosurgery, Charitéplatz 1, 10117 Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program, Charitéplatz 1, 10117 Berlin, Germany.
| |
Collapse
|
3
|
Du Y, Cai X, Zheng Y, Long A, Zhang M, Chen M, Zhang W, Zhu J, Guo J, Yang C. Research advances and trends in anatomy from 2013 to 2023: A visual analysis based on CiteSpace and VOSviewer. Clin Anat 2024. [PMID: 38651194 DOI: 10.1002/ca.24168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
As the cornerstone of medicine, the development of anatomy is related to many disciplines and fields and has received extensive attention from researchers. How to integrate and grasp the cutting-edge information in this field quickly is a challenge for researchers, so the aim of this study is to analyze research in anatomy using CiteSpace and VOSviewer in order to identify research hotspots and future directions. To offer a fresh viewpoint for assessing the academic influences of researchers, nations, or institutions on anatomy, and to examine the development of hotspots in anatomical study and to forecast future trends. A total of 4637 anatomy-related publications from 2013 to 2023 were collected from Web of Science Core Collection databases. Their temporal distribution, spatial distribution, cited authors, co-cited journals, keywords, and disciplinary connections in the literature were analyzed using CiteSpace and VOSviewer, and a knowledge graph was constructed. The temporal distribution shows a general fluctuation in the amount of literature published from 2013 to 2023. In spatial distribution, the total number of published articles was highest in the United States, the United Kingdom, and China, the United States leading. Tubbs, Rhoton, Iwanaga, and LaPrade are important authors in anatomy. Clinical Anatomy, Surgical and Radiologic Anatomy, and Journal of Anatomy were the most highly cited journals. Analysis of keywords and citation emergence showed that the research hotspots and trends in anatomy focused mainly on anatomy education, digital technology, and surgical management. At the same time, anatomy showed a trend toward multidisciplinary crossover, developing closer relationships with molecular biology, immunology, and clinical medicine. Current research in anatomy focuses on innovative reform of the educational model and the application and promotion of digital technology. Also, multidisciplinary cross-fertilization is an inevitable trend for the future development of anatomy.
Collapse
Affiliation(s)
- Yikuan Du
- Central Laboratory, The Tenth Affiliated Hospital of Southern Medical University, Dongguan, China
| | - Xiaolin Cai
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Ye Zheng
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Aoxue Long
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Mengting Zhang
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Mianhai Chen
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Weichui Zhang
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Jinfeng Zhu
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Jinhua Guo
- Department of anatomy, Guangdong Medical University, Dongguan, China
| | - Chun Yang
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated Hospital, School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
- Department of anatomy, Guangdong Medical University, Dongguan, China
| |
Collapse
|
4
|
Clarke K, Al-Mukhtar A, Alim L, Nimer A, Hatfield E, Sabharwal S, Syed S. Using Mixed Reality Simulation to Improve Junior Medical Trainees' Preparedness to Manage High-Acuity Trauma. BMJ Open Qual 2024; 13:e002575. [PMID: 38589055 PMCID: PMC11015284 DOI: 10.1136/bmjoq-2023-002575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024] Open
Abstract
High-acuity trauma necessitates experienced and rapid intervention to prevent patient harm. However, upskilling junior trainees through hands-on management of real trauma cases is rarely feasible without compromising patient safety. This quality education report sought to investigate whether a simulation course operated via mixed reality (MR) headset devices (Microsoft HoloLens) could enhance the clinical knowledge recall and preparedness to practice of junior trainees with no prior experience managing trauma.The Plan-Do-Study-Act quality improvement method was used to refine six emergency trauma vignettes compatible with an MR teaching platform. Each vignette was curated by a multidisciplinary team of orthopaedic surgeons, clinical fellows and experts in simulation-based medical education. As a baseline assessment, a 2-hour emergency trauma course was delivered using traditional didactic methods to a cohort of pre-registration medical students with no clinical exposure to high-acuity trauma (n=16). Next, we delivered the MR simulation to an equivalent cohort (n=32). Clinical knowledge scores derived from written test papers were recorded for each group during and 2 weeks after each course. Each attendee's end-of-rotation clinical supervisor appraisal grade was recorded, as determined by a consultant surgeon who supervised participants during a 2-week placement on a major trauma ward. Balancing measures included participant feedback and validated cognitive load questionnaires (National Aeronautics and Space Administration-Task Load Index).Overall, attendees of the MR simulation course achieved and sustained higher clinical knowledge scores and were more likely to receive a positive consultant supervisor appraisal. This project serves as a proof of concept that MR wearable technologies can be used to improve clinical knowledge recall and enhance the preparedness to practice of novice learners with otherwise limited clinical exposure to high-acuity trauma.
Collapse
Affiliation(s)
- Kirsty Clarke
- Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Aws Al-Mukhtar
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College Surgical Innovation Centre, Imperial College London, London, UK
| | - Lina Alim
- Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Amr Nimer
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College Surgical Innovation Centre, Imperial College London, London, UK
| | | | | | - Sadie Syed
- Imperial College Healthcare NHS Trust, London, UK
- Imperial College Surgical Innovation Centre, Imperial College London, London, UK
| |
Collapse
|
5
|
Sumunar DSEW, Stathakarou N, Davoody N. User acceptance of neuroanatomy virtual reality course: Contrasting views between undergraduate and postgraduate students. Health Informatics J 2024; 30:14604582241260601. [PMID: 38838637 DOI: 10.1177/14604582241260601] [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] [Indexed: 06/07/2024]
Abstract
Virtual Reality (VR) offers cost-efficient and effective tools for spatial 3-dimensional neuroanatomy learning. Enhancing users-system relationship is necessary for successful adoption of the system. The current study aimed to evaluate students' acceptance of VR for neuroanatomy. An exploratory qualitative case study based on Unified Theory of Acceptance and Use of Technology (UTAUT) framework carried out at [details omitted for double-anonymized peer review]. Participants in this study were students participating in a VR session, followed by a semi-structured interview. Deductive framework analysis employed to retrieve students' perspective and experience. A total of six undergraduate and 13 postgraduate students participated in this study. The following UTAUT constructs validated to be significant: Performance Expectancy, Effort Expectancy and Facilitating Conditions. System usability, depth of lesson and hardware optimizations are among concern for further improvements. In conclusion, students are accepting VR as a neuroanatomy learning resource. The findings of this research highlight the importance of system performance and user-centred approach in technology development for educational purposes.
Collapse
Affiliation(s)
- Dimas Septian Eko Wahyu Sumunar
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
- Department of Health Policy and Management, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Natalia Stathakarou
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
| | - Nadia Davoody
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
| |
Collapse
|
6
|
García-Robles P, Cortés-Pérez I, Nieto-Escámez FA, García-López H, Obrero-Gaitán E, Osuna-Pérez MC. Immersive virtual reality and augmented reality in anatomy education: A systematic review and meta-analysis. ANATOMICAL SCIENCES EDUCATION 2024; 17:514-528. [PMID: 38344900 DOI: 10.1002/ase.2397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 04/04/2024]
Abstract
The purpose of this review was to (1) analyze the effectiveness of immersive virtual reality (iVR) and augmented reality (AR) as teaching/learning resources (collectively called XR-technologies) for gaining anatomy knowledge compared to traditional approaches and (2) gauge students' perceptions of the usefulness of these technologies as learning tools. This meta-analysis, previously registered in PROSPERO (CRD42023423017), followed PRISMA guidelines. A systematic bibliographical search, without time parameters, was conducted through four databases until June 2023. A meta-analytic approach investigated knowledge gains and XR's usefulness for learning. Pooled effect sizes were estimated using Cohen's standardized mean difference (SMD) and 95% confidence intervals (95% CI). A single-group proportional meta-analysis was conducted to quantify the percentage of students who considered XR devices useful for their learning. Twenty-seven experimental studies, reporting data from 2199 health sciences students, were included for analysis. XR-technologies yielded higher knowledge gains than traditional approaches (SMD = 0.40; 95% CI = 0.22 to 0.60), especially when used as supplemental/complementary learning resources (SMD = 0.52; 95% CI = 0.40 to 0.63). Specifically, knowledge performance using XR devices outperformed textbooks and atlases (SMD = 0.32; 95% CI = 0.10 to 0.54) and didactic lectures (SMD = 1.00; 95% CI = 0.57 to 1.42), especially among undergraduate students (SMD = 0.41; 95% CI = 0.20 to 0.62). XR devices were perceived to be more useful for learning than traditional approaches (SMD = 0.54; 95% CI = 0.04 to 1), and 80% of all students who used XR devices reported these devices as useful for learning anatomy. Learners using XR technologies demonstrated increased anatomy knowledge gains and considered these technologies useful for learning anatomy.
Collapse
Affiliation(s)
- Paloma García-Robles
- FRATERNIDAD Muprespa, Linares, Spain
- Department of Health Sciences, University of Jaén, Jaén, Spain
| | | | - Francisco Antonio Nieto-Escámez
- Department of Psychology, University of Almeria, Almeria, Spain
- Center for Neuropsychological Assessment and Rehabilitation (CERNEP), Almeria, Spain
| | - Héctor García-López
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | | | | |
Collapse
|
7
|
Mohammad NK, Rajab IA, Mutar MT, Ismail M. Enhancing neuro-ophthalmic surgical education: The role of neuroanatomy and 3D digital technologies - An overview. Surg Neurol Int 2024; 15:106. [PMID: 38628527 PMCID: PMC11021076 DOI: 10.25259/sni_120_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 03/01/2024] [Indexed: 04/19/2024] Open
Abstract
Background Neuro-ophthalmology, bridging neurology and ophthalmology, highlights the nervous system's crucial role in vision, encompassing afferent and efferent pathways. The evolution of this field has emphasized the importance of neuroanatomy for precise surgical interventions, presenting educational challenges in blending complex anatomical knowledge with surgical skills. This review examines the interplay between neuroanatomy and surgical practices in neuro-ophthalmology, aiming to identify educational gaps and suggest improvements. Methods A literature search across databases such as PubMed, Scopus, and Web of Science was conducted, focusing on the implications of neuroanatomy in neuro-ophthalmic surgery education and practice. The review synthesizes insights from both recent and foundational studies to highlight current understandings and future research directions, particularly in educational approaches. Results Findings indicate that 3D digital modeling and virtual reality have significantly enhanced neuroophthalmic surgical education by providing immersive and engaging learning experiences. For instance, detailed 3D brain atlases offer comprehensive resources for understanding the central nervous system's normal and pathological states. Although studies show that 3D and traditional 2D methods achieve similar post-test results, 3D methods notably improve engagement and motivation, suggesting a shift toward more interactive learning environments. Conclusion Integrating both traditional and innovative educational tools is crucial for the progression of neuro-ophthalmic surgical training. This balance helps overcome educational hurdles and better prepare future surgeons. Continuous research and collaboration are essential to refine educational strategies, ultimately aiming to enhance patient care in neuro-ophthalmology.
Collapse
Affiliation(s)
- Najah K. Mohammad
- Department of Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Ibrahim Ali Rajab
- Department of Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Mohammed T. Mutar
- Department of Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Mustafa Ismail
- Department of Neurosurgery, Teaching Hospital, Baghdad, Iraq
| |
Collapse
|
8
|
Aridan N, Bernstein-Eliav M, Gamzo D, Schmeidler M, Tik N, Tavor I. Neuroanatomy in virtual reality: Development and pedagogical evaluation of photogrammetry-based 3D brain models. ANATOMICAL SCIENCES EDUCATION 2024; 17:239-248. [PMID: 37997182 DOI: 10.1002/ase.2359] [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: 07/18/2023] [Revised: 10/29/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
Anatomy studies are an essential part of medical training. The study of neuroanatomy in particular presents students with a unique challenge of three-dimensional spatial understanding. Virtual Reality (VR) has been suggested to address this challenge, yet the majority of previous reports have implemented computer-generated or imaging-based models rather than models of real brain specimens. Using photogrammetry of real human bodies and advanced editing software, we developed 3D models of a real human brain at different stages of dissection. Models were placed in a custom-built virtual laboratory, where students can walk around freely, explore, and manipulate (i.e., lift the models, rotate them for different viewpoints, etc.). Sixty participants were randomly assigned to one of three learning groups: VR, 3D printed models or read-only, and given 1 h to study the white matter tracts of the cerebrum, followed by theoretical and practical exams and a learning experience questionnaire. We show that following self-guided learning in virtual reality, students demonstrate a gain in spatial understanding and an increased satisfaction with the learning experience, compared with traditional learning approaches. We conclude that the models and virtual lab described in this work may enhance learning experience and improve learning outcomes.
Collapse
Affiliation(s)
- Nadav Aridan
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Michal Bernstein-Eliav
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Gamzo
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Maya Schmeidler
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Niv Tik
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Ido Tavor
- Department of Anatomy and Anthropology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
9
|
Trandzhiev M, Koundouras T, Milev M, Laleva L, Mitev A, Stoykov V, Dimitrov N, Maslarski I, Nakov V, Spiriev T. The Evaluation of Virtual Reality Neuroanatomical Training Utilizing Photorealistic 3D Models in Limited Body Donation Program Settings. Cureus 2024; 16:e55377. [PMID: 38562356 PMCID: PMC10983822 DOI: 10.7759/cureus.55377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Background Neuroanatomy is one of the most complex areas of anatomy to teach to medical students. Traditional study methods such as atlases and textbooks are mandatory but require significant effort to conceptualize the three-dimensional (3D) aspects of the neuroanatomical regions of interest. Objectives To test the feasibility of human anatomy teaching medical students in a virtual reality (VR) immersive environment using photorealistic three-dimensional models (PR3DM) of human anatomy, in a limited anatomical body donation program. Methods We used surface scanning technology (photogrammetry) to create PR3DM of brain dissections. The 3D models were uploaded to VR headsets and used in immersive environment classes to teach second-year medical students. Twenty-eight medical students (mean age 20.11, SD 1.42), among which 19 females (n=28/67.9%) and nine males (n=28/32.1%), participated in the study. The students had either none or minimal experience with the use of VR devices. The duration of the study was three months. After completing the curriculum, a survey was done to examine the results. Results The average rating of the students for their overall experience with the method is 4.57/5 (SD=0.63). The "Possibility to study models from many points of view" and "Good Visualization of the models" were the most agreed upon advantages, with 24 students (n=28, 85.7%), and 95% confidence intervals (CI) [0.6643, 0.9532]. The limited availability of the VR headsets was the major disadvantage as perceived by the students, with 11 students (n=28, 39.3%), 95% CI [0.2213, 0.5927] having voted for the option. The majority of the students (25) (n=28, 89.2%, SD=0.31) agreed with the statement that the use of VR facilitated their neuroanatomy education. Conclusion This study shows the future potential of this model of training in limited cadaver dissection options to provide students with modern technological methods of training. Our first results indicate a prominent level of student satisfaction from VR training with minimum negative reactions to the nature of headsets. The proof of concept for the application of photorealistic models in VR neuroanatomy training combined with the initial results of appreciation among the students predisposes the application of the method on a larger scale, adding a nuance to the traditional anatomy training methods. The low number of headsets used in the study limits the generalization of the results but offers possibilities for future perspectives of research.
Collapse
Affiliation(s)
- Martin Trandzhiev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Theodoros Koundouras
- Department of Anatomy and Histology, Pathology and Forensic Medicine, University Hospital Lozenetz, Medical Faculty, Sofia University, Sofia, BGR
| | - Milko Milev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Lili Laleva
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Atanas Mitev
- Department of Anatomy and Histology, Pathology and Forensic Medicine, University Hospital Lozenetz, Medical Faculty, Sofia University, Sofia, BGR
| | - Viktor Stoykov
- Department of Anatomy and Histology, Pathology and Forensic Medicine, University Hospital Lozenetz, Medical Faculty, Sofia University, Sofia, BGR
| | - Nikolay Dimitrov
- Department of Anatomy and Histology, Pathology and Forensic Medicine, University Hospital Lozenetz, Medical Faculty, Sofia University, Sofia, BGR
| | - Ivan Maslarski
- Department of Anatomy and Histology, Pathology and Forensic Medicine, University Hospital Lozenetz, Medical Faculty, Sofia University, Sofia, BGR
| | - Vladimir Nakov
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| |
Collapse
|
10
|
Leung R, Shi G. Building Your Future Holographic Mentor: Can We Use Mixed Reality Holograms for Visual Spatial Motor Skills Acquisition in Surgical Education? Surg Innov 2024; 31:82-91. [PMID: 37916497 PMCID: PMC10773164 DOI: 10.1177/15533506231211844] [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] [Indexed: 11/03/2023]
Abstract
Learning surgical skills require critical visual-spatial motor skills. Current learning methods employ costly and limited in-person teaching in addition to supplementation by videos, textbooks, and cadaveric labs. Increasingly limited healthcare resources and in-person training has led to growing concerns for skills acquisition of trainees. Recent Mixed Reality (MR) devices offer an attractive solution to these resource barriers by providing three-dimensional holographic representations of reality that mimic in-person experiences in a portable, individualized, and cost-effective form. We developed and evaluated two holographic MR models to explore the feasibility of visual-spatial motor skill acquisition from a technical development, learning, and usability perspective. In our first, a pair of holographic hands were created and projected in front of the trainee, and participants were evaluated on their ability to learn complex hand motions in comparison to traditional methods of video and apprenticeship-based learning. The second model displayed a 3D holographic model of the middle and inner ear with labeled anatomical structures which users could explore and user experience feedback was obtained. Our studies demonstrated that scores between MR and apprenticeship learning were comparable. All felt MR was an effective learning tool and most noted that the MR models were better than existing didactic methods of learning. Identified advantages of MR included the ability to provide true 3D spatial representation, improved visualization of smaller structures in detail by upscaling the models, and improved interactivity. Our results demonstrate that holographic learning is able to mimic in-person learning for visual-spatial motor skills and could be a new effective form of self-directed apprenticeship learning.
Collapse
Affiliation(s)
- Regina Leung
- Division of Plastic and Reconstructive Surgery, Western University, London, Canada
| | - Ge Shi
- Division of General Surgery, Western University, London, Canada
| |
Collapse
|
11
|
Lee HD, Huh Y, Kim S, Baek JW, Lee H, Park SM, Kim JK. Educational effects of and satisfaction with mixed-reality-based major trauma care simulator: A preliminary evaluation. Medicine (Baltimore) 2024; 103:e36816. [PMID: 38181252 PMCID: PMC10766292 DOI: 10.1097/md.0000000000036816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
Mixed reality (MR) is a hybrid system that projects virtual elements into reality. MR technology provides immersive learning using various real-world tools. However, studies on educational programs using MR are scarce. This study aimed to investigate the educational effects of and satisfaction with an MR-based trauma decision-making simulator. A total 40 of trainees self-selected to participate in this study. All of them participated in the MR trauma simulator for approximately 30 minutes and conducted voluntary learning without any external help. Declarative knowledge, measured using 20 multiple-choice questions, was assessed before and after MR trauma training. To confirm the educational effect, test scores before and after MR trauma training were compared using a paired t-test. Student satisfaction after training was measured using a ten-item questionnaire rated on a five-point Likert scale. A pretest-posttest comparison yielded a significant increase in declarative knowledge. The percentage of correct answers to multiple choice questions increased (from a mean of 42.3, SD 12.4-54.8, SD 13) after the MR-based trauma assessment and treatment training (P < .001). Of the participants, 79.45% were satisfied with the overall experience of using the MR simulator. This study demonstrated a meaningful educational effect of the MR-based trauma training system even after a short training time.
Collapse
Affiliation(s)
- Han-Dong Lee
- Department of Orthopedic Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Yo Huh
- Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sora Kim
- Gyeonggi South Regional Trauma Center, Ajou University Hospital, Suwon, Republic of Korea
| | - Ji-Woong Baek
- Department of Orthopedic Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Hojun Lee
- Armed Forces Trauma Center, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Sang-Min Park
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jin-Kak Kim
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| |
Collapse
|
12
|
Ting M, Windrix C, Tanaka K, Butt A. Comments on "Patient-embodied virtual reality: A promising yet developing educational model for practitioner". PATIENT EDUCATION AND COUNSELING 2023; 117:107979. [PMID: 37714810 DOI: 10.1016/j.pec.2023.107979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/08/2023] [Indexed: 09/17/2023]
Affiliation(s)
- Michael Ting
- College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Casey Windrix
- Department of Anesthesiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kenichi Tanaka
- Department of Anesthesiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Amir Butt
- Department of Anesthesiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| |
Collapse
|
13
|
Montané E, Vilaplana C, Riera J, Pujol M, Méndez M, Mas A, Vara A, Parés D. Medical Students' Opinion of Their Learning Process. MEDICAL SCIENCE EDUCATOR 2023; 33:1183-1190. [PMID: 37886280 PMCID: PMC10597930 DOI: 10.1007/s40670-023-01873-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 10/28/2023]
Abstract
Introduction The opinion of students is of utmost importance to identify areas of improvement in undergraduate studies. Medical schools would use this information to plan actions to ensure that the students achieve the necessary medical knowledge. The aim of this study was to analyse the opinion of medical students about their learning process and to analyse the influence of their experience according to their year of medical degree. Methods A questionnaire including 21 items, divided into four sections (motivation, theory lectures, hospital internships, and research) and two overall questions, was distributed among eligible 246 students. Each item was scored from 1 (strongly disagree) to 5 (strongly agree). The opinions of intermediate-year students of medical degree (3rd and 4th) were compared to late-year students (5th and 6th). Results A total of 148 students answered the questionnaire (60.2% response rate). The mean scores for overall student motivation and teaching quality were 6.15 and 7.10, respectively. The student-teacher interaction and new learning technological tools were considered important for student motivation. The only differences found between the two groups of students were that late-year students wished to become part of a medical team and to learn writing scientific papers more than the intermediate-year students. Conclusions This questionnaire revealed that the year of career had little influence on the medical students' opinion on their learning process during their undergraduate studies. Late-year students rated highest on being more interested in being part of a medical team and their knowledge on writing scientific articles. The use of new technologies and the student-teacher interaction is key to motivate students.
Collapse
Affiliation(s)
- Eva Montané
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Department of Clinical Pharmacology, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Barcelona, Spain
| | - Cristina Vilaplana
- Experimental TB Unit, Department of Microbiology, Northern Metropolitan Clinical Laboratory, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
- Infectious Diseases and International Health Clinical Division, Northern Metropolitan Management of the Catalan Institute of Health, Badalona, Spain
| | - Joan Riera
- Medical School at Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Marina Pujol
- Medical School at Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Maria Méndez
- Department of Paediatrics, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Albert Mas
- Medical School at Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Angel Vara
- Medical School at Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - David Parés
- Department of Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
- Department of Surgery, Universitat Autònoma de Barcelona, Bellaterra, Spain
| |
Collapse
|
14
|
Jukna Š, Puteikis K, Mameniškienė R. Perception of neurology among undergraduate medical students - what can be done to counter neurophobia during clinical studies? BMC MEDICAL EDUCATION 2023; 23:447. [PMID: 37328733 DOI: 10.1186/s12909-023-04405-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/26/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND PURPOSE With a global increase in the burden of neurological diseases, the aversion towards neurology (neurophobia) may challenge the sufficient provision of new specialists in this field. We investigated the possible determinants of neurophobia among medical students and its influence on the intent to pursue neurology residency. METHODS From September 2021 to March 2022, an online questionnaire was distributed to medical students in Lithuania. It included questions about knowledge, confidence, interest, and teaching quality of various medical specialties (including neurology), as well as the willingness to choose neurology for residency. RESULTS Eight hundred fifty-two students responded to the survey (77.2% female) - they rated neurology as significantly more difficult than other medical areas and lacked confidence in assessing patients with neurological problems (p < 0.001). However, neurology was selected as one of the most interesting subjects and was reportedly well-taught. The prevalence of neurophobia among respondents was 58.9%. Most of them (207, 87.7%) indicated that neurology professors positively affected their outlook towards this medical specialty - such experience was associated with lower odds of neurophobia (odds ratio (OR) = 0.383, 95% confidence interval (CI) = 0.223 to 0.658). Being less neurophobic (OR = 1.785, 95% CI = 1.152 to 2.767) and having conducted neurology research (OR = 2.072, 95% CI = 1.145 to 3.747) increased the odds of a student being willing to pursue a career in neurology. CONCLUSION Neurophobia was frequent among students in Lithuania and was inversely related to the positive influence by neurology professors. Together with previous research experience in the field, low levels of neurophobia were associated with the inclination to enter neurology residency.
Collapse
Affiliation(s)
- Šarūnas Jukna
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Rūta Mameniškienė
- Center of Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
| |
Collapse
|
15
|
Stackhouse AA, Rafi D, Walls R, Dodd RV, Badger K, Davies DJ, Brown CA, Cowell A, Meeran K, Halse O, Kinross J, Lupton M, Hughes EA, Sam AH. Knowledge Attainment and Engagement Among Medical Students: A Comparison of Three Forms of Online Learning. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:373-380. [PMID: 37101695 PMCID: PMC10124742 DOI: 10.2147/amep.s391816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/28/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE This study compared knowledge attainment and student enjoyment and engagement between clinical case vignette, patient-testimony videos and mixed reality (MR) teaching via the Microsoft HoloLens 2, all delivered remotely to third year medical students. The feasibility of conducting MR teaching on a large scale was also assessed. SETTING & PARTICIPANTS Medical students in Year 3 at Imperial College London participated in three online teaching sessions, one in each format. All students were expected to attend these scheduled teaching sessions and to complete the formative assessment. Inclusion of their data used as part of the research trial was optional. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was performance on a formative assessment, which served to compare knowledge attainment between three forms of online learning. Moreover, we aimed to explore student engagement with each form of learning via a questionnaire, and also feasibility of applying MR as a teaching tool on a large scale. Comparisons between performances on the formative assessment between the three groups were investigated using a repeated measures two-way ANOVA. Engagement and enjoyment were also analysed in the same manner. RESULTS A total of 252 students participated in the study. Knowledge attainment of students using MR was comparable with the other two methods. Participants reported higher enjoyment and engagement (p<0.001) for the case vignette method, compared with MR and video-based teaching. There was no difference in enjoyment or engagement ratings between MR and the video-based methods. CONCLUSION This study demonstrated that the implementation of MR is an effective, acceptable, and feasible way of teaching clinical medicine to undergraduate students on a large scale. However, case-based tutorials were found to be favoured most by students. Future work could further explore the best uses for MR teaching within the medical curriculum.
Collapse
Affiliation(s)
| | - Damir Rafi
- Imperial College School of Medicine, Imperial College London, London, UK
| | - Risheka Walls
- Imperial College School of Medicine, Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
| | - Rebecca V Dodd
- Imperial College School of Medicine, Imperial College London, London, UK
| | - Kerry Badger
- Imperial College School of Medicine, Imperial College London, London, UK
| | - Daniel J Davies
- Imperial College School of Medicine, Imperial College London, London, UK
| | - Celia A Brown
- Warwick Medical School, Department of Medicine, Warwick, UK
| | - Adrian Cowell
- Imperial College School of Medicine, Imperial College London, London, UK
| | - Karim Meeran
- Imperial College School of Medicine, Imperial College London, London, UK
| | - Omid Halse
- Imperial College School of Medicine, Imperial College London, London, UK
| | - James Kinross
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Martin Lupton
- Imperial College School of Medicine, Imperial College London, London, UK
| | | | - Amir H Sam
- Imperial College School of Medicine, Imperial College London, London, UK
| |
Collapse
|
16
|
Shih SF, Hsu LL, Hsieh SI. Effects of Digital Learning and Virtual Reality in Port-A Catheter Training Course for Oncology Nurses: A Mixed-Methods Study. Healthcare (Basel) 2023; 11:healthcare11071017. [PMID: 37046944 PMCID: PMC10094602 DOI: 10.3390/healthcare11071017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
In-service education for oncology nurses usually adopts didactic teaching. This study investigated the effects of virtual reality (VR) and a digital learning-based Port-A-catheter educational course for oncology nurses. A mixed-methods research design was employed, with a convenience sample of 43 nurses from a regional teaching hospital in Taiwan participating. Measurements were taken at three time points: pre-test, 1st post-test, and 2nd post-test. The data was analyzed using descriptive statistics and repeated ANOVA tests. Results showed significant improvement in Port-A-catheter knowledge and skill levels (p < 0.0001) and high learning attitude and satisfaction scores of 4.29 ± 0.46 and 4.31 ± 0.58 points, respectively. Five qualitative themes emerged, highlighting the realistic VR scenarios, VR practice’s usefulness, willingness to learn with VR, VR system limitations, and the potential for future courses. The study concluded that a VR-based educational course effectively enhanced nurses’ knowledge, skills, learning attitude, and satisfaction, recommending the inclusion of diverse clinical scenarios for practical learning.
Collapse
Affiliation(s)
- Shu-Feng Shih
- Department of Nursing, Koo Foundation Sun Yat-Sen Cancer Center, Taipei City 11259, Taiwan
| | - Li-Ling Hsu
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung 203301, Taiwan
| | - Suh-Ing Hsieh
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan
| |
Collapse
|
17
|
Brown KE, Heise N, Eitel CM, Nelson J, Garbe BA, Meyer CA, Ivie KR, Clapp TR. A Large-Scale, Multiplayer Virtual Reality Deployment: A Novel Approach to Distance Education in Human Anatomy. MEDICAL SCIENCE EDUCATOR 2023; 33:409-421. [PMID: 36820280 PMCID: PMC9933027 DOI: 10.1007/s40670-023-01751-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 05/31/2023]
Abstract
The arrival of COVID-19 restrictions and the increasing demand of online instruction options posed challenges to education communities worldwide, especially in human anatomy. In response, Colorado State University developed and deployed an 8-week-long large-scale virtual reality (VR) course to supplement online human anatomy instruction. Students (n = 75) received a VR-capable laptop and head-mounted display and participated in weekly synchronous group laboratory sessions with instructors. The software enabled students to remotely collaborate in a common virtual space to work with human anatomy using an artist-rendered cadaver. Qualitative data were collected on student engagement, confidence, and reactions to the new technology. Quantitative data assessed student knowledge acquisition and retention of anatomical spatial relationships. Results indicated that students performed better in the online course (mean = 82.27%) when compared to previous in-person laboratories (mean = 80.08%). The utilization of VR promoted student engagement and increased opportunities for student interaction with teaching assistants, peers, and course content. Notably, students reported benefits that focused on unique aspects of their virtual learning environment, including the ability to infinitely scale the cadaver and walk inside and around anatomical structures. Results suggested that using VR was equivalent to 2D methods in student learning and retention of anatomical relationships. Overall, the virtual classroom maintained the rigor of traditional gross anatomy laboratories without negatively impacting student examination scores and provided a high level of accessibility, without compromising learner engagement. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01751-w.
Collapse
Affiliation(s)
- Katelyn E. Brown
- Department of Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO USA
| | - Natascha Heise
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA USA
| | - Chad M. Eitel
- Department of Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO USA
| | - Jordan Nelson
- School of Medicine, University of Colorado Anschutz, Aurora, CO USA
| | | | - Carolyn A. Meyer
- Department of Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO USA
| | - Kenneth R Ivie
- Department of Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO USA
| | - Tod R. Clapp
- Department of Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO USA
| |
Collapse
|
18
|
Furr Stimming E, Soni M. Educating Residents and Students in the Clinic. Neurol Clin 2023; 41:215-229. [DOI: 10.1016/j.ncl.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
19
|
Abstract
SUMMARY STATEMENT Simulation-based training using virtual reality head-mounted displays (VR-HMD) is increasingly being used within the field of medical education. This article systematically reviews and appraises the quality of the literature on the use of VR-HMDs in medical education. A search in the databases PubMed/MEDLINE, Embase, ERIC, Scopus, Web of Science, Cochrane Library, and PsychINFO was carried out. Studies were screened according to predefined exclusion criteria, and quality was assessed using the Medical Education Research Study Quality Instrument. In total, 41 articles were included and thematically divided into 5 groups: anatomy, procedural skills, surgical procedures, communication skills, and clinical decision making. Participants highly appreciated using VR-HMD and rated it better than most other training methods. Virtual reality head-mounted display outperformed traditional methods of learning surgical procedures. Although VR-HMD showed promising results when learning anatomy, it was not considered better than other available study materials. No conclusive findings could be synthesized regarding the remaining 3 groups.
Collapse
|
20
|
Lin YC, Lin PC, Lin PC, Lin CY, Kabasawa Y, Choi YK, Huang HL. Combining augmented and virtual reality simulation training to improve geriatric oral care performance in healthcare assistants: A randomized controlled trial. Digit Health 2023; 9:20552076231203891. [PMID: 37780060 PMCID: PMC10540595 DOI: 10.1177/20552076231203891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/08/2023] [Indexed: 10/03/2023] Open
Abstract
Objective Healthcare assistants (HCAs) are frontline caregivers for older adults. This study evaluated the effectiveness of combining augmented reality (AR) and virtual reality (VR) to implement oral healthcare simulation training for HCAs. Methods An experimental design was adopted. HCAs were recruited and randomly assigned to an AR/VR group (n = 40) or a control group (n = 40). The AR/VR group received 2.5 h of AR/VR training. Participants were trained on the Bass brushing technique through AR and on scenario-based oral care procedures for various physical and oral health conditions in older adults through VR. A self-administered questionnaire was employed to collect data before and after the training. Generalized estimating equations were used to analyze the differences between pretest and posttest results. Results After the training, the HCAs in the AR/VR group achieved a significantly greater increase in their level of oral care-related knowledge (β = 2.55, effect size [ES] = 1.62), self-efficacy (β = 4.23, ES = 0.75), and behavioral intention (β = 2.10, ES = 0.55) relative to the control group. Conclusion This study revealed that the application of an AR/VR simulation system can effectively improve the geriatric oral care performance of HCAs.
Collapse
Affiliation(s)
- Yi-Ching Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung
- Department of Oral Hygiene, Shu-Zen Junior College of Medicine and Management, Kaohsiung
| | - Pei-Chen Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung
| | - Pei-Chao Lin
- College of Nursing, Kaohsiung Medical University, Kaohsiung
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung
| | - Cheng-Yu Lin
- Department of Radio, TV and Film, Shih Hsin University, Taipei
| | - Yuji Kabasawa
- Oral Care for Systemic Health Support, Faculty of Dentistry, School of Oral Health Care Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yong-Keum Choi
- Department of Oral Hygiene, Division of Health Sciences, Sun Moon University, Asan-si, Republic of Korea
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung
| |
Collapse
|
21
|
Heys S, Downe S, McKeown M, Thomson G. The design, delivery and evaluation of 'Human Perspectives VR': An immersive educational programme designed to raise awareness of contributory factors for a traumatic childbirth experience and PTSD. PLoS One 2022; 17:e0276263. [PMID: 36322586 PMCID: PMC9629609 DOI: 10.1371/journal.pone.0276263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND A traumatic childbirth experience affects ~30% of women each year, with negative impacts on maternal, infant, and family wellbeing. Women classified as vulnerable or marginalised are those more likely to experience a psychologically traumatising birth. A key contributory factor for a traumatic childbirth experience is women's relationships with maternity care providers. AIMS To develop, design and evaluate an immersive educational programme for maternity care providers to raise awareness of traumatic childbirth experiences amongst vulnerable groups, and ultimately to improve women's experiences of childbirth. METHODS A critical pedagogical approach that utilised virtual reality (VR) underpinned the design and development of the educational programme. This involved: a) collecting vulnerable/disadvantaged women's experiences of birth via interviews; b) analysing data collected to identify key hotspots for traumatic experiences within interpersonal patient-provider relationships to develop a script; c) filming the script with professional actors creating a first person perspective via VR technology; d) using existing literature to inform the theoretical and reflective aspects of the programme; e) conducting an evaluation of the education programme using pre-and post-evaluation questionnaires and a follow-up focus group. FINDINGS Human Perspective VR was very well received. Participants considered the content to have enhanced their reflective practice and increased their knowledge base regarding contributory factors associated with a traumatic childbirth experience. A need for further work to implement learning into practice was highlighted. CONCLUSION While further research is needed to evaluate the impact of the programme, Human Perspective VR programme offers an innovative approach to reflective education and to enhance participants' care practices.
Collapse
Affiliation(s)
- Stephanie Heys
- Maternity Learning and Development Lead, Consultant Midwife, The Northwest Ambulance Service, The University of Central Lancashire, Preston, United Kingdom
- * E-mail:
| | - Soo Downe
- Professor of Midwifery Studies, The University of Central Lancashire, Preston, United Kingdom
| | - Mick McKeown
- Professor of Democratic Mental Health, The University of Central Lancashire, Preston, United Kingdom
| | - Gill Thomson
- Professor of Perinatal Health, The University of Central Lancashire, Preston, United Kingdom
| |
Collapse
|
22
|
Newman HJ, Meyer AJ, Wilkinson TJ, Pather N, Carr SE. Technology enhanced neuroanatomy teaching techniques: A focused BEME systematic review of current evidence: BEME Guide No. 75. MEDICAL TEACHER 2022; 44:1069-1080. [PMID: 35225142 DOI: 10.1080/0142159x.2022.2039382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND In response to growing curriculum pressures and reduced time dedicated to teaching anatomy, research has been conducted into developing innovative teaching techniques. This raises important questions for neuroanatomy education regarding which teaching techniques are most beneficial for knowledge acquisition and long-term retention, and how they are best implemented. This focused systematic review aims to provide a review of technology-enhanced teaching methods available to neuroanatomy educators, particularly in knowledge acquisition and long-term retention, compared to traditional didactic techniques, and proposes reasons for why they work in some contexts. METHODS Electronic databases were searched from January 2015 to June 2020 with keywords that included combinations of 'neuroanatomy,' 'technology,' 'teaching,' and 'effectiveness' combined with Boolean phrases 'AND' and 'OR.' The contexts and outcomes for all studies were summarised while coding, and theories for why particular interventions worked were discussed. RESULTS There were 4287 articles identified for screening, with 13 studies included for final analysis. There were four technologies of interest: stereoscopic views of videos, stereoscopic views of images, augmented reality (AR), and virtual reality (VR). No recommendation for a particular teaching method was made in six studies (46%) while recommendations (from weak to moderate) were made in seven studies (54%). There was weak to moderate evidence for the efficacy of stereoscopic images and AR, and no difference in the use of stereoscopic videos or VR compared to controls. CONCLUSIONS To date, technology-enhanced teaching is not inferior to teaching by conventional didactic methods. There are promising results for these methods in complex spatial anatomy and reducing cognitive load. Possible reasons for why interventions worked were described including students' engagement with the object, cognitive load theory, complex spatial relationships, and the technology learning curve. Future research may build on the theorised explanations proposed here and develop and test innovative technologies that build on prior research.
Collapse
Affiliation(s)
- Hamish J Newman
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Perth, Australia
- Health Professions Education, School of Allied Health, The University of Western Australia, Perth, Australia
| | - Amanda J Meyer
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Perth, Australia
| | - Tim J Wilkinson
- Education Unit, University of Otago, Christchurch, New Zealand
| | - Nalini Pather
- Department of Anatomy, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Sandra E Carr
- Health Professions Education, School of Allied Health, The University of Western Australia, Perth, Australia
| |
Collapse
|
23
|
Chandrasekaran R, Radzi S, Kai PZ, Rajalingam P, Rotgans J, Mogali SR. A validated instrument measuring students' perceptions on plastinated and three-dimensional printed anatomy tools. ANATOMICAL SCIENCES EDUCATION 2022; 15:850-862. [PMID: 34694750 DOI: 10.1002/ase.2147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
Due to the modernization of the medical curriculum and technological advancements, anatomy education has evolved beyond cadaveric dissection alone. Plastination techniques, three-dimensional (3D) modeling, and 3D printing technologies have progressively gained importance. However, there are limited valid and reliable surveys to evaluate students' perceptions of these new anatomy tools. Hence, this study aimed to develop a validated instrument to measure students' learning satisfaction, self-efficacy, humanistic values, and perceived limitations of plastinated and 3D printed models. A 41-item survey (five-point Likert scale, 1 = strongly disagree to 5 = strongly agree) was administered to Year 1 undergraduate medical students following a randomized controlled crossover study that evaluated plastinated and 3D printed cardiac and neck models. Ninety-six responses were received, and a factor analysis was performed with the Kaiser-Meyer-Olkin sampling adequacy of 0.878. The confirmatory factor analysis yielded a 4-factor, 19 items model that had a good fit with the latent constructs of x 2 (147) = 211.568, P < 0.001, root mean square error of approximation = 0.068, root mean square residual = 0.064, comparative fit index = 0.946, and Tucker Lewis index = 0.937. The Cronbach's alpha for the individual factors ranged from 0.74 to 0.95, indicating good internal consistency. This demonstrated a psychometrically valid and reliable instrument to measure students' perceptions toward plastinated and 3D printed models.
Collapse
Affiliation(s)
- Ramya Chandrasekaran
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Shairah Radzi
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Peh Zhen Kai
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Preman Rajalingam
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Jerome Rotgans
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | | |
Collapse
|
24
|
Vandenbossche V, Van de Velde J, Avet S, Willaert W, Soltvedt S, Smit N, Audenaert E. Digital body preservation: Technique and applications. ANATOMICAL SCIENCES EDUCATION 2022; 15:731-744. [PMID: 35578771 DOI: 10.1002/ase.2199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 02/25/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
High-fidelity anatomical models can be produced with three-dimensional (3D) scanning techniques and as such be digitally preserved, archived, and subsequently rendered through various media. Here, a novel methodology-digital body preservation-is presented for combining and matching scan geometry with radiographic imaging. The technique encompasses joining layers of 3D surface scans in an anatomical correct spatial relationship. To do so, a computed tomography (CT) volume is used as template to join and merge different surface scan geometries by means of nonrigid registration into a single environment. In addition, the use and applicability of the generated 3D models in digital learning modalities is presented. Finally, as computational expense is usually the main bottleneck in extended 3D applications, the influence of mesh simplification in combination with texture mapping on the quality of 3D models was investigated. The physical fidelity of the simplified meshes was evaluated in relation to their resolution and with respect to key anatomical features. Large- and medium-scale features were well preserved despite extensive 3D mesh simplification. Subtle fine-scale features, particular in curved areas demonstrated the major limitation to extensive mesh size reduction. Depending on the local topography, workable mesh sizes ranging from 10% to 3% of the original size could be obtained, making them usable in various learning applications and environments.
Collapse
Affiliation(s)
- Vicky Vandenbossche
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Joris Van de Velde
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stind Avet
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Wouter Willaert
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Gastrointestinal Surgery, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stian Soltvedt
- Department of Informatics, Institute for Informatics, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, Bergen, Norway
| | - Noeska Smit
- Department of Informatics, Institute for Informatics, University of Bergen, Bergen, Norway
- Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, Bergen, Norway
| | - Emmanuel Audenaert
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Orthopedic Surgery and Traumatology, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Op3Mech Research Group, Department of Electromechanics, Faculty of Applied Engineering, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
25
|
Mendez-Lopez M, Juan MC, Molla R, Fidalgo C. Evaluation of an Augmented Reality Application for Learning Neuroanatomy in Psychology. ANATOMICAL SCIENCES EDUCATION 2022; 15:535-551. [PMID: 33866682 DOI: 10.1002/ase.2089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
Neuroanatomy is difficult for psychology students because of spatial visualization and the relationship among brain structures. Some technologies have been implemented to facilitate the learning of anatomy using three-dimensional (3D) visualization of anatomy contents. Augmented reality (AR) is a promising technology in this field. A mobile AR application to provide the visualization of morphological and functional information of the brain was developed. A sample of 67 students of neuropsychology completed tests for visuospatial ability, anatomical knowledge, learning goals, and experience with technologies. Subsequently, they performed a learning activity using one of the visualization methods considered: a 3D method using the AR application and a two-dimensional (2D) method using a textbook to color, followed by questions concerning their satisfaction and knowledge. After using the alternative method, the students expressed their preference. The two methods improved knowledge equally, but the 3D method obtained higher satisfaction scores and was more preferred by students. The 3D method was also more preferred by the students who used this method during the activity. After controlling for the method used in the activity, associations were found between the preference of the 3D method because of its usability and experience with technologies. These results found that the AR application was highly valued by students to learn and was as effective as the textbook for this purpose.
Collapse
Affiliation(s)
- Magdalena Mendez-Lopez
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, Teruel, Spain
- Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - M Carmen Juan
- Institute of Industrial Control Systems and Computing, Universitat Politècnica de València, Valencia, Spain
| | - Ramon Molla
- Institute of Industrial Control Systems and Computing, Universitat Politècnica de València, Valencia, Spain
| | - Camino Fidalgo
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, Teruel, Spain
- Aragon Health Research Institute (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| |
Collapse
|
26
|
Alam P, Salimi A, ElHawary H, Sioufi K, Papanastasiou C, Thibaudeau S. The effects of COVID-19 on Canadian surgical residents' education and wellness. CANADIAN MEDICAL EDUCATION JOURNAL 2022; 13:50-56. [PMID: 35572023 PMCID: PMC9099164 DOI: 10.36834/cmej.72160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has challenged health care systems. We sought to comprehend the impact of the COVID-19 pandemic on surgical residents' education and mental well-being across Canada. METHODS An online 51-question survey was distributed to surgical residents across all 17 Canadian post- graduate surgical residency programs. The questionnaire contained questions concerning demographic factors, perceived effects of COVID-19 pandemic on surgical training and residents' mental health (categorically demonstrating whether it improved, stayed the same, or worsened). Health habits were measured as continuous variables and compared before and during the pandemic. Additionally, participants reported the performance of wellness offices' response to their needs during this crisis. RESULTS A total of 122 out of 650 (19%) residents from all surgical specialities anonymously completed the survey. The majority (68%) reported a worsening in their surgical training. 94% of participants favored online teaching as a complementary method to in-person teaching. As to health habits, 38% reported a rise in their alcohol consumption and time spent seated. Only a minority (25%) felt happier and 41% reported experiencing more anxiety in comparison to surgical training pre-COVID-19. Merely 14% reported benefitting from wellness programs. CONCLUSION The COVID-19 pandemic had a negative effect on the perceived quality of surgical training, education, and resident mental health. There is an urgent need to reconsider the implemented measures in medical education and urge us to develop better agendas to face the current or future waves.
Collapse
Affiliation(s)
- Peter Alam
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Quebec, Canada
| | - Ali Salimi
- Department of Ophthalmology, Faculty of Medicine, McGill University, Quebec, Canada
| | - Hassan ElHawary
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Quebec, Canada
| | | | | | - Stephanie Thibaudeau
- Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Quebec, Canada
| |
Collapse
|
27
|
Rao Bhagavathula V, Bhagavathula V, Moinis RS, Chaudhuri JD. The Integration of Prelaboratory Assignments within Neuroanatomy Augment Academic Performance, Increase Engagement, and Enhance Intrinsic Motivation in Students. ANATOMICAL SCIENCES EDUCATION 2022; 15:576-586. [PMID: 33829667 DOI: 10.1002/ase.2084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/11/2021] [Accepted: 04/03/2021] [Indexed: 06/12/2023]
Abstract
The study of neuroanatomy imposes a significant cognitive load on students since it includes huge factual information and therefore demands diverse learning strategies. In addition, a significant amount of teaching is carried out through human brain demonstrations, due to limited opportunities for cadaveric dissection. However, reports suggest that students often attend these demonstrations with limited preparation, which detrimentally impacts their learning. In the context of student learning, greater levels of engagement and intrinsic motivation (IM) are associated with better academic performance. However, the maintenance of engagement and the IM of students in neuroanatomy is often challenging for educators. Therefore, this study aimed to explore the role of prelaboratory assignments (PLAs) in the improvement of academic performance, augmentation of engagement, and enhancement of IM in occupational therapy students enrolled in a human neuroanatomy course. One cohort of students in the course was expected to complete PLAs prior to each brain demonstration session. The PLAs contained a list of structures, and students were expected to write a brief anatomical description of each structure. Another cohort of students who were not provided with similar PLAs constituted the control group. Students who completed PLAs had a higher score on the final examinations as compared to students who were not required to complete PLAs. These students also demonstrated greater engagement and IM, and indicated that they perceived PLAs to be valuable in the learning of neuroanatomy. Therefore, PLAs represent a useful teaching tool in the neuroanatomy curriculum.
Collapse
Affiliation(s)
| | - Viswakanth Bhagavathula
- Department of Forensic Medicine and Toxicology, Kanachur Institute of Medical Sciences and Hospital, Mangalore, India
| | - Rohan S Moinis
- Department of Forensic Medicine and Toxicology, Kanachur Institute of Medical Sciences and Hospital, Mangalore, India
| | - Joydeep Dutta Chaudhuri
- School of Occupational Therapy, College of Health and Pharmacy, Husson University, Bangor, Maine
| |
Collapse
|
28
|
Guckert M, Milanovic K, Hannig J, Simon D, Wettengl T, Evers D, Kleyer A, Keller T, Pitt J. The Disruption of Trust in the Digital Transformation Leading to Health 4.0. Front Digit Health 2022; 4:815573. [PMID: 35419559 PMCID: PMC8995643 DOI: 10.3389/fdgth.2022.815573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
The specification and application of policies and guidelines for public health, medical education and training, and screening programmes for preventative medicine are all predicated on trust relationships between medical authorities, health practitioners and patients. These relationships are in turn predicated on a verbal contract that is over two thousand years old. The impact of information and communication technology (ICT), underpinning Health 4.0, has the potential to disrupt this analog relationship in several dimensions; but it also presents an opportunity to strengthen it, and so to increase the take-up and effectiveness of new policies. This paper develops an analytic framework for the trust relationships in Health 4.0, and through three use cases, assesses a medical policy, the introduction of a new technology, and the implications of that technology for the trust relationships. We integrate this assessment in a set of actionable recommendations, in particular that the trust framework should be part of the design methodology for developing and deploying medical applications. In a concluding discussion, we advocate that, in a post-pandemic world, IT to support policies and programmes to address widespread socio-medical problems with mental health, long Covid, physical inactivity and vaccine misinformation will be essential, and for that, strong trust relationships between all the stakeholders are absolutely critical.
Collapse
Affiliation(s)
- Michael Guckert
- Cognitive Information Systems, KITE-Kompetenzzentrum für Informationstechnologie, Technische Hochschule Mittelhessen-University of Applied Science, Friedberg, Germany
- Department of MND-Mathematik, Naturwissenschaften und Datenverarbeitung, Technische Hochschule Mittelhessen-University of Applied Science, Friedberg, Germany
| | - Kristina Milanovic
- Department of Electrical and Electronic Engineering, Imperial College London, London, United Kingdom
| | - Jennifer Hannig
- Cognitive Information Systems, KITE-Kompetenzzentrum für Informationstechnologie, Technische Hochschule Mittelhessen-University of Applied Science, Friedberg, Germany
| | - David Simon
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | | | - Arnd Kleyer
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Till Keller
- Department of Internal Medicine I, Cardiology, Justus-Liebig-University Gießen, Gießen, Germany
| | - Jeremy Pitt
- Department of Electrical and Electronic Engineering, Imperial College London, London, United Kingdom
| |
Collapse
|
29
|
Chytas D, Salmas M, Skandalakis GP, Troupis TG. Augmented and virtual reality in anatomy education: Can they be effective if they do not provide immersive experience? ANATOMICAL SCIENCES EDUCATION 2022; 15:431-433. [PMID: 34236773 DOI: 10.1002/ase.2119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/03/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Dimitrios Chytas
- Department of Anatomy, School of Physiotherapy, University of Peloponnese, Sparta, Greece
| | - Marios Salmas
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios P Skandalakis
- First Department of Neurosurgery, "Evangelismos" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore G Troupis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
30
|
Scott H, Griffin C, Coggins W, Elberson B, Abdeldayem M, Virmani T, Larson-Prior LJ, Petersen E. Virtual Reality in the Neurosciences: Current Practice and Future Directions. Front Surg 2022; 8:807195. [PMID: 35252318 PMCID: PMC8894248 DOI: 10.3389/fsurg.2021.807195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/30/2021] [Indexed: 01/05/2023] Open
Abstract
Virtual reality has made numerous advancements in recent years and is used with increasing frequency for education, diversion, and distraction. Beginning several years ago as a device that produced an image with only a few pixels, virtual reality is now able to generate detailed, three-dimensional, and interactive images. Furthermore, these images can be used to provide quantitative data when acting as a simulator or a rehabilitation device. In this article, we aim to draw attention to these areas, as well as highlight the current settings in which virtual reality (VR) is being actively studied and implemented within the field of neurosurgery and the neurosciences. Additionally, we discuss the current limitations of the applications of virtual reality within various settings. This article includes areas in which virtual reality has been used in applications both inside and outside of the operating room, such as pain control, patient education and counseling, and rehabilitation. Virtual reality's utility in neurosurgery and the neurosciences is widely growing, and its use is quickly becoming an integral part of patient care, surgical training, operative planning, navigation, and rehabilitation.
Collapse
Affiliation(s)
- Hayden Scott
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- *Correspondence: Hayden Scott
| | - Connor Griffin
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - William Coggins
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Brooke Elberson
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Mohamed Abdeldayem
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Tuhin Virmani
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Linda J. Larson-Prior
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Erika Petersen
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| |
Collapse
|
31
|
Lee DK, Choi H, Jheon S, Jo YH, Im CW, Il SY. Development of an Extended Reality Simulator for Basic Life Support Training. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2022; 10:4900507. [PMID: 35937462 PMCID: PMC9342859 DOI: 10.1109/jtehm.2022.3152365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/12/2022] [Accepted: 01/31/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Extended Reality (XR) is a simultaneous combination of the virtual and real world. This paper presents the details of the framework and development methods for an XR basic life support (XR-BLS) simulator, as well as the results of an expert usability survey. METHODS The XR-BLS simulator was created by employing a half-torso manikin in a virtual reality environment and using BLS education data that is in line with the 2020 American Heart Association guidelines. A head-mounted display (HMD) and hand-tracking device were used to perform chest compressions and ventilation and to enable the use of an automated external defibrillator in a virtual environment. A usability study of the XR-BLS simulator through an expert survey was also conducted. The survey consisted of a total of 8 items: 3, 2, and 2 questions about the ease of use of XR-BLS, delivery of training, and artificial intelligence (AI) instructor in the simulator, respectively. RESULTS The XR simulator was developed, and the expert survey showed that it was easy to use, the BLS training was well delivered, and the interaction with the AI instructor was clear and understandable. DISCUSSION/CONCLUSION The XR-BLS simulator is useful as it can conduct BLS education without requiring instructors and trainees to gather.
Collapse
Affiliation(s)
- Dong Keon Lee
- Department of Emergency MedicineSeoul National University Bundang HospitalSeongnam13620Republic of Korea
- Department of Emergency MedicineSeoul National University College of MedicineSeoul03080Republic of Korea
| | - Haneul Choi
- TETRASIGNUM CorporationSeoul05839Republic of Korea
| | - Sanghoon Jheon
- Department of Thoracic and Cardiovascular SurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineSeoul03080Republic of Korea
| | - You Hwan Jo
- Department of Emergency MedicineSeoul National University Bundang HospitalSeongnam13620Republic of Korea
- Department of Emergency MedicineSeoul National University College of MedicineSeoul03080Republic of Korea
| | - Chang Woo Im
- Department of Emergency MedicineSeoul National University Bundang HospitalSeongnam13620Republic of Korea
| | - Song Young Il
- THIRTEENTH FLOOR CorporationSeoul06798Republic of Korea
| |
Collapse
|
32
|
Thenmozhi S, Girija S, Viswanathan KN, Badrinath AK. A Pandemic of Webinars in the COVID Era—Can It be the Way Forward? JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1742465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Introduction Conferences are important and sometimes mandatory to update the clinician with latest knowledge. Attending conferences requires planning, expenditure, and leave from work. Webinars have become the new normal in the coronavirus disease (COVID) era. We surveyed the esteemed medical fraternity on their opinion on webinars.
Methods This was conducted as an online survey (Survey Monkey) through personal electronic mails and social media with 24 questions. Details on demographic profile, specialization and affiliation, experience, choice of frequency of webinar sessions, suitable platform, mode of intimation of webinars, number of days for prior intimation, appropriate timing of the day and week, and ideas on payment options were enquired. Need for technical assistance, choice of topic for discussions, methods to make webinars more interactive, availability of recorded content, and impact on clinical practice were also assessed.
Results A total of 235 medical professionals voiced their opinion; 67% were < 35 years of age and 49% were residents. An average of 2 to 3 webinars per month (33.8%), conducted on weekdays (63%), after 6 p.m. (54%) in the form of case discussion (67.3%) or lectures from experts (55%) with at least 7 days' notice (41.7%) was the most common choice; free webinars were the wish of 56.1% participants and 28% felt webinars would definitely impact practice.
Conclusion Webinars are welcoming even after the COVID era and should go hand-in-hand with conventional conferences. Virtual learning experience should be optimized by proper scheduling of multiple simultaneous events and converting them into interlinked or serial events.
Collapse
Affiliation(s)
- Senthilvelan Thenmozhi
- Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Subramanian Girija
- Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - K Neelakantan Viswanathan
- Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | | |
Collapse
|
33
|
Effectiveness of Virtual Reality-Based Training on Oral Healthcare for Disabled Elderly Persons: A Randomized Controlled Trial. J Pers Med 2022; 12:jpm12020218. [PMID: 35207706 PMCID: PMC8879228 DOI: 10.3390/jpm12020218] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/16/2022] [Accepted: 02/01/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Virtual reality (VR) technology is a widely used training tool in medical education. The present study aimed to evaluate the effectiveness of VR training of oral hygiene students on providing oral healthcare to disabled elderly persons. (2) Methods: A randomized controlled trial was conducted. In 2021, oral hygiene students were randomly assigned to a VR experimental group (EG; n = 11) and a control group (CG; n = 12). The EG received two-hour, thrice-repeated VR-based training interventions at 2-week, 4-week, and 6-week follow-ups. The CG received no VR-based interventions. Data were collected using a self-administered questionnaire before and immediately after each intervention. We performed generalized estimating equations to compare the responses. (3) Results: The EG exhibited a more significant improvement in oral care-related knowledge, attitude, self-efficacy, and intention at the 6-week follow-up than the CG. The students’ intention to assist the elderly in using interdental brushes (β = 0.91), with soft tissue cleaning (β = 0.53), and with oral desensitization (β = 0.53), and to have regular dental visits (β = 0.61) improved significantly at the 6-week follow-up. (4) Conclusions: VR training positively affected students’ knowledge, attitude, self-efficacy, and intentions on providing oral healthcare to disabled elderly persons.
Collapse
|
34
|
Application of virtual reality in neurosurgery: Patient missing. A systematic review. J Clin Neurosci 2021; 95:55-62. [PMID: 34929652 DOI: 10.1016/j.jocn.2021.11.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/06/2021] [Accepted: 11/26/2021] [Indexed: 01/18/2023]
Abstract
Virtual reality (VR) technology had its earliest developments in the 1970s in the U.S. Air Force and has since evolved into a budding area of scientific research with many practical medical purposes. VR shows a high potential to benefit to learners and trainees and improve surgery through enhanced preoperative planning and efficiency in the operating room. Neurosurgery is a field of medicine in which VR has been accepted early on as a useful and promising tool for neuro-navigation planning. Through recent technological developments, VR further increased its level of immersion, accessibility and intuitive use for surgeons and students and now reveals a therapeutic potential for patients. In this paper, we systematically reviewed the neurosurgery literature regarding the use of VR as an assistance for surgery or a tool centered on patients' care. A literature search conducted according to PRISMA guidelines resulted in the screening of 125 abstracts and final inclusion of 100 original publications reviewed. The review shows that neurosurgeons are now relatively familiar with VR technologies (N = 95 articles) for their training and practice. VR technologies are useful for education, pain management and rehabilitation in neurosurgical patients. Nevertheless, the current patient-oriented use of VR remains limited (N = 5 articles). Successful surgery does not only depend on the surgeon's skills and preparation, but also on patients' education, comfort, empowerment and care. Therefore further clinical research is needed to promote the direct use of VR technologies by patients in neurosurgery.
Collapse
|
35
|
New neuroanatomy learning paradigms for the next generation of trainees: A novel literature-based 3D methodology. Clin Neurol Neurosurg 2021; 210:106948. [DOI: 10.1016/j.clineuro.2021.106948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/29/2022]
|
36
|
Sandrone S, Carlson CE. Future of Neurology & Technology: Virtual and Augmented Reality in Neurology and Neuroscience Education: Applications and Curricular Strategies. Neurology 2021; 97:740-744. [PMID: 34187858 DOI: 10.1212/wnl.0000000000012413] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Virtual reality and augmented reality have become increasingly prevalent in our lives. They are changing the way we see and interact with the world and have started percolating through medical education. In this article, we reviewed the key applications of virtual and augmented realities in neurology and neuroscience education and discussed barriers and opportunities for implementation in the curriculum. Although the long-term benefits of these approaches over more traditional learning methods and the optimal curricular balance remain mostly unexplored, virtual and augmented reality can change how we teach neurology and neuroscience.
Collapse
Affiliation(s)
- Stefano Sandrone
- From the Department of Brain Sciences (S.S.), Imperial College London, United Kingdom; and Medical College of Wisconsin (C.E.C.).
| | - Chad E Carlson
- From the Department of Brain Sciences (S.S.), Imperial College London, United Kingdom; and Medical College of Wisconsin (C.E.C.)
| |
Collapse
|
37
|
Wijeysingha ES, Chin VY, Lian CP. Utilising virtual environments for radiation therapy teaching and learning. J Med Imaging Radiat Sci 2021; 52:S83-S95. [PMID: 34344633 DOI: 10.1016/j.jmir.2021.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/15/2021] [Accepted: 07/07/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Modern radiation therapy undergraduate education comprises the illustration of theoretical, technical concepts in a classroom setting, coupled with the acquisition of practical handling and patient communication skills within the clinical environment. In recent years, there has been renewed interest in the application of virtual environments to education, despite ongoing inconclusive evidence on the use of virtual environments for enhancing student educational achievement. AIM AND OBJECTIVES The aim of our research is to evaluate a custom-built 3D virtual radiation oncology department created within Second Life®, an online virtual world, as an alternative to traditional physical classroom-based didactic instruction, in tandem with a Virtual Environment for Radiotherapy Training (VERT) system, for the peer support and training of junior radiation therapy students in their first and second year of undergraduate studies. To achieve this aim, we investigated learning achievement outcomes, knowledge retention over a 2-week time interval and learner self-perceived confidence post-instruction, using both quantitative and qualitative analysis. METHODS Institutional ethics approval was granted for an exempted review. Participants were currently enrolled undergraduate Year 1 and Year 2 students at our institution. Student participants were randomised into two groups; the control group attended a face-to-face classroom session centred on the illustration of theoretical, technical concepts, while the intervention group attended a virtual classroom session online on Second Life®, where similar content was delivered. Both groups then attended a VERT practical session to acquire practical handling and communication skills in radiation therapy. Upon completion of the sessions, confidence surveys, knowledge-based written and practical assessments were administered to the student participants. RESULTS We found that the instructional session conducted within the custom-built 3D virtual radiation oncology department in Second Life® compared to the traditional didactic classroom setting increased undergraduate Year 1 radiation therapy students' perceived confidence to a greater extent compared to Year 2 students, in performing radiation therapy treatment procedures. In addition, our findings revealed that overall learning achievement outcomes and knowledge retention scores between Second Life® and non- Second Life® student participants were closely similar and statistically insignificant. Thematic analysis of the confidence survey questionnaires revealed that the students in general desired more clinical hands-on practice. DISCUSSION Second Life® is equally effective in disseminating theoretical, technical course content delivery to undergraduate radiation therapy students. The use of virtual environments appears to have increased the perceived confidence of the Year 1 undergraduate students to a greater extent compared to the Year 2 undergraduates, suggesting that the adoption of virtual environments early in the students' educational journey can have a positive effect on students' learning experience. CONCLUSIONS AND RECOMMENDATIONS The development and use of our custom-built Second Life® radiation oncology department provides a novel way of delivering remote, virtual training instruction to undergraduate radiation therapy students over traditional, didactic classroom instructional delivery. We recommend, based on the results of this pilot study, that future research can involve a larger study sample of undergraduate RT students, to explore both the short-term and long-term impact of virtual environments on student learning outcomes across their enrolled years of study. This would in turn mean progressive attempts to revamp our existing curricula structure, to deliberately incorporate the use of virtual environments, especially during early undergraduate years, towards enhanced modern RT education.
Collapse
Affiliation(s)
| | - Vale Yw Chin
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Cheryl Pl Lian
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore.
| |
Collapse
|
38
|
Chytas D, Salmas M, Nikolaou VS, Babis GC, Kaseta MK, Skandalakis GP, Chronopoulos E. Letter to the Editor Regarding: "Innovative Educational Pathways in Spine Surgery: Advanced Virtual Reality-Based Training". World Neurosurg 2021; 148:225. [PMID: 33770835 DOI: 10.1016/j.wneu.2020.10.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 10/21/2022]
Affiliation(s)
- Dimitrios Chytas
- Department of Anatomy, School of Medicine, European University of Cyprus, Engomi, Cyprus.
| | - Marios Salmas
- Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios S Nikolaou
- 2(nd) Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Nea Ionia, Greece
| | - George C Babis
- 2(nd) Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Nea Ionia, Greece
| | - Maria-Kyriaki Kaseta
- 2(nd) Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Nea Ionia, Greece
| | - Georgios P Skandalakis
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Efstathios Chronopoulos
- 2(nd) Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Nea Ionia, Greece
| |
Collapse
|
39
|
Barteit S, Lanfermann L, Bärnighausen T, Neuhann F, Beiersmann C. Augmented, Mixed, and Virtual Reality-Based Head-Mounted Devices for Medical Education: Systematic Review. JMIR Serious Games 2021; 9:e29080. [PMID: 34255668 PMCID: PMC8299342 DOI: 10.2196/29080] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/06/2021] [Accepted: 05/08/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Augmented reality (AR), mixed reality (MR), and virtual reality (VR), realized as head-mounted devices (HMDs), may open up new ways of teaching medical content for low-resource settings. The advantages are that HMDs enable repeated practice without adverse effects on the patient in various medical disciplines; may introduce new ways to learn complex medical content; and may alleviate financial, ethical, and supervisory constraints on the use of traditional medical learning materials, like cadavers and other skills lab equipment. OBJECTIVE We examine the effectiveness of AR, MR, and VR HMDs for medical education, whereby we aim to incorporate a global health perspective comprising low- and middle-income countries (LMICs). METHODS We conducted a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) and Cochrane guidelines. Seven medical databases (PubMed, Cochrane Library, Web of Science, Science Direct, PsycINFO, Education Resources Information Centre, and Google Scholar) were searched for peer-reviewed publications from January 1, 2014, to May 31, 2019. An extensive search was carried out to examine relevant literature guided by three concepts of extended reality (XR), which comprises the concepts of AR, MR, and VR, and the concepts of medicine and education. It included health professionals who took part in an HMD intervention that was compared to another teaching or learning method and evaluated with regard to its effectiveness. Quality and risk of bias were assessed with the Medical Education Research Study Quality Instrument, the Newcastle-Ottawa Scale-Education, and A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies of Interventions. We extracted relevant data and aggregated the data according to the main outcomes of this review (knowledge, skills, and XR HMD). RESULTS A total of 27 studies comprising 956 study participants were included. The participants included all types of health care professionals, especially medical students (n=573, 59.9%) and residents (n=289, 30.2%). AR and VR implemented with HMDs were most often used for training in the fields of surgery (n=13, 48%) and anatomy (n=4, 15%). A range of study designs were used, and quantitative methods were clearly dominant (n=21, 78%). Training with AR- and VR-based HMDs was perceived as salient, motivating, and engaging. In the majority of studies (n=17, 63%), HMD-based interventions were found to be effective. A small number of included studies (n=4, 15%) indicated that HMDs were effective for certain aspects of medical skills and knowledge learning and training, while other studies suggested that HMDs were only viable as an additional teaching tool (n=4, 15%). Only 2 (7%) studies found no effectiveness in the use of HMDs. CONCLUSIONS The majority of included studies suggested that XR-based HMDs have beneficial effects for medical education, whereby only a minority of studies were from LMICs. Nevertheless, as most studies showed at least noninferior results when compared to conventional teaching and training, the results of this review suggest applicability and potential effectiveness in LMICs. Overall, users demonstrated greater enthusiasm and enjoyment in learning with XR-based HMDs. It has to be noted that many HMD-based interventions were small-scale and conducted as short-term pilots. To generate relevant evidence in the future, it is key to rigorously evaluate XR-based HMDs with AR and VR implementations, particularly in LMICs, to better understand the strengths and shortcomings of HMDs for medical education.
Collapse
Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health, Heidelberg, Germany
| | | | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg, Germany
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, United States
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Florian Neuhann
- Heidelberg Institute of Global Health, Heidelberg, Germany
- School of Medicine and Clinical Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia
| | | |
Collapse
|
40
|
van Deursen M, Reuvers L, Duits JD, de Jong G, van den Hurk M, Henssen D. Virtual reality and annotated radiological data as effective and motivating tools to help Social Sciences students learn neuroanatomy. Sci Rep 2021; 11:12843. [PMID: 34145335 PMCID: PMC8213773 DOI: 10.1038/s41598-021-92109-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/04/2021] [Indexed: 02/07/2023] Open
Abstract
Neuroanatomy as a subject is important to learn, because a good understanding of neuroanatomy supports the establishment of a correct diagnosis in neurological patients. However, rapid changes in curricula reduced time assigned to study (neuro)anatomy. Therefore, it is important to find alternative teaching methods to study the complex three-dimensional structure of the brain. The aim of this manuscript was to explore the effectiveness of Virtual Reality (VR) in comparison with Radiological Data (RaD) as suitable learning methods to build knowledge and increase motivation for learning neuroanatomy. Forty-seven students (mean age of 19.47 ± 0.54 years; 43 females; 4 males) were included; 23 students comprised the VR group. Both methods showed to improve knowledge significantly, the improvement between groups was not different. The RaD group showed to have a significantly higher score on expectancy than students in the VR group. Task value scores regarding finding a task interesting, useful and fun were found to be significantly different in favor of the VR group. Consequently, significant higher Motivation scores were found in the VR group. Motivation and expectancy, however, did not moderate learning results, whereas task value impacted the results in favour of the VR group. This study concludes that VR and RaD are effective and diverting methods to learn neuroanatomy, with VR being more motivating than RaD. Future research should investigate motivation and task value when using VR over a longer period of time.
Collapse
Affiliation(s)
- Margot van Deursen
- Department of Educational Sciences, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands
| | - Laura Reuvers
- Department of Educational Sciences, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands
| | - Jacobus Dylan Duits
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guido de Jong
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marianne van den Hurk
- Department of Educational Sciences, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands
| | - Dylan Henssen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.
| |
Collapse
|
41
|
Stromberga Z, Phelps C, Smith J, Moro C. Teaching with Disruptive Technology: The Use of Augmented, Virtual, and Mixed Reality (HoloLens) for Disease Education. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1317:147-162. [PMID: 33945136 DOI: 10.1007/978-3-030-61125-5_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Modern technologies are often utilised in schools or universities with a variety of educational goals in mind. Of particular interest is the enhanced interactivity and engagement offered by mixed reality devices such as the HoloLens, as well as the ability to explore anatomical models of disease using augmented and virtual realities. As the students are required to learn an ever-increasing number of diseases within a university health science or medical degree, it is crucial to consider which technologies provide value to educators and students. This chapter explores the opportunities for using modern disruptive technologies to teach a curriculum surrounding disease. For relevant examples, a focus will be placed on asthma as a respiratory disease which is increasing in prevalence, and stroke as a neurological and cardiovascular disease. The complexities of creating effective educational curricula around these diseases will be explored, along with the benefits of using augmented reality and mixed reality as viable teaching technologies in a range of use cases.
Collapse
Affiliation(s)
- Zane Stromberga
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Charlotte Phelps
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Jessica Smith
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Christian Moro
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia.
| |
Collapse
|
42
|
Bogomolova K, Sam AH, Misky AT, Gupte CM, Strutton PH, Hurkxkens TJ, Hierck BP. Development of a Virtual Three-Dimensional Assessment Scenario for Anatomical Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:385-393. [PMID: 33465814 PMCID: PMC8252734 DOI: 10.1002/ase.2055] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 12/18/2020] [Accepted: 01/13/2021] [Indexed: 05/30/2023]
Abstract
In anatomical education three-dimensional (3D) visualization technology allows for active and stereoscopic exploration of anatomy and can easily be adopted into medical curricula along with traditional 3D teaching methods. However, most often knowledge is still assessed with two-dimensional (2D) paper-and-pencil tests. To address the growing misalignment between learning and assessment, this viewpoint commentary highlights the development of a virtual 3D assessment scenario and perspectives from students and teachers on the use of this assessment tool: a 10-minute session of anatomical knowledge assessment with real-time interaction between assessor and examinee, both wearing a HoloLens and sharing the same stereoscopic 3D augmented reality model. Additionally, recommendations for future directions, including implementation, validation, logistic challenges, and cost-effectiveness, are provided. Continued collaboration between developers, researchers, teachers, and students is critical to advancing these processes.
Collapse
Affiliation(s)
- Katerina Bogomolova
- Department of SurgeryLeiden University Medical CenterLeidenthe Netherlands
- Center for Innovation of Medical EducationLeiden University Medical CenterLeidenthe Netherlands
| | - Amir H. Sam
- Medical Education Research UnitImperial College School of MedicineImperial College LondonLondonUK
| | - Adam T. Misky
- St Mary's HospitalImperial College Healthcare NHS TrustLondonUK
| | - Chinmay M. Gupte
- Medical Education Research UnitImperial College School of MedicineImperial College LondonLondonUK
- St Mary's HospitalImperial College Healthcare NHS TrustLondonUK
| | | | | | - Beerend P. Hierck
- Center for Innovation of Medical EducationLeiden University Medical CenterLeidenthe Netherlands
- Department of Anatomy and EmbryologyLeiden University Medical CenterLeidenthe Netherlands
- Leiden Teachers' AcademyLeiden UniversityLeidenthe Netherlands
| |
Collapse
|
43
|
Moro C, Birt J, Stromberga Z, Phelps C, Clark J, Glasziou P, Scott AM. Virtual and Augmented Reality Enhancements to Medical and Science Student Physiology and Anatomy Test Performance: A Systematic Review and Meta-Analysis. ANATOMICAL SCIENCES EDUCATION 2021; 14:368-376. [PMID: 33378557 DOI: 10.1002/ase.2049] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/18/2020] [Accepted: 12/24/2020] [Indexed: 05/24/2023]
Abstract
Virtual and augmented reality have seen increasing employment for teaching within medical and health sciences programs. For disciplines such as physiology and anatomy, these technologies may disrupt the traditional modes of teaching and content delivery. The objective of this systematic review and meta-analysis is to evaluate the impact of virtual reality or augmented reality on knowledge acquisition for students studying preclinical physiology and anatomy. The protocol was submitted to Prospero and literature search undertaken in PubMed, Embase, ERIC, and other databases. Citations were reviewed and articles published in full assessing learning or knowledge acquisition in preclinical physiology and anatomy from virtual or augmented reality were included. Of the 919 records found, 58 eligible articles were reviewed in full-text, with 8 studies meeting full eligibility requirements. There was no significant difference in knowledge scores from combining the eight studies (626 participants), with the pooled difference being a non-significant increase of 2.9 percentage points (95% CI [-2.9; 8.6]). For the four studies comparing virtual reality to traditional teaching, the pooled treatment effect difference was 5.8 percentage points (95% CI [-4.1; 15.7]). For the five studies comparing augmented reality to traditional teaching, the pooled treatment effect difference was 0.07 (95% CI [-7.0; 7.2]). Upon review of the literature, it is apparent that educators could benefit from adopting assessment processes that evaluate three-dimensional spatial understanding as a priority in physiology and anatomy. The overall evidence suggests that although test performance is not significantly enhanced with either mode, both virtual and augmented reality are viable alternatives to traditional methods of education in health sciences and medical courses.
Collapse
Affiliation(s)
- Christian Moro
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - James Birt
- Faculty of Society and Design, Bond University, Gold Coast, Queensland, Australia
| | - Zane Stromberga
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Charlotte Phelps
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| |
Collapse
|
44
|
Gulick V, Graves D, Ames S, Krishnamani PP. Effect of a Virtual Reality-Enhanced Exercise and Education Intervention on Patient Engagement and Learning in Cardiac Rehabilitation: Randomized Controlled Trial. J Med Internet Res 2021; 23:e23882. [PMID: 33856355 PMCID: PMC8085751 DOI: 10.2196/23882] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/10/2020] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cardiac rehabilitation (CR) is clinically proven to reduce morbidity and mortality; however, many eligible patients do not enroll in treatment. Furthermore, many enrolled patients do not complete their full course of treatment. This is greatly influenced by socioeconomic factors but is also because of patients' lack of understanding of the importance of their care and a lack of motivation to maintain attendance. OBJECTIVE This study aims to explore the potential benefits of virtual reality (VR) walking trails within CR treatment, specifically with regard to patient knowledge retention, satisfaction with treatment, and the overall attendance of treatment sessions. METHODS New CR patients were enrolled and randomized on a rolling basis to either the control group or intervention group. Intervention patients completed their time on the treadmill with VR walking trails, which included audio-recorded education, whereas control patients completed the standard of care therapy. Both groups were assisted by nursing staff for all treatment sessions. Primary outcomes were determined by assessing 6-minute walk test improvement. In addition, secondary outcomes of patients' cardiac knowledge and satisfaction were assessed via a computer-based questionnaire; patient adherence to the recommended number of sessions was also monitored. Cardiac knowledge assessment included a prerehabilitation education quiz, and the same quiz was repeated at patients' final visit and again at the 2-month follow-up. The satisfaction questionnaire was completed at the final visit. RESULTS Between January 2018 and May 2019, 72 patients were enrolled-41 in the intervention group and 31 in the control group. On the basis of the results of the prerehabilitation and postrehabilitation 6-minute walk test, no significant differences were observed between the intervention and control groups (P=.64). No statistical differences were observed between groups in terms of education (P=.86) or satisfaction (P=.32) at any time point. The control group had statistically more favorable rates of attendance, as determined by the risk group comparison (P=.02) and the comparison of the rates for completing the minimum number of sessions (P=.046), but no correlation was observed between the study group and reasons for ending treatment. CONCLUSIONS Although no improvements were seen in the VR intervention group over the control group, it is worth noting that limitations in the study design may have influenced these outcomes, not the medium itself. Furthermore, the qualitative information suggests that patients may have indeed enjoyed their experience with VR, even though quantitative satisfaction data did not capture this. Further considerations for how and when VR should be applied to CR are suggested in this paper. TRIAL REGISTRATION ClinicalTrials.gov NCT03945201; https://clinicaltrials.gov/ct2/show/NCT03945201.
Collapse
Affiliation(s)
- Victoria Gulick
- Information Services & Technologies, Jefferson Health, Philadelphia, PA, United States
| | - Daniel Graves
- Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA, United States
| | - Shannon Ames
- Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA, United States
| | | |
Collapse
|
45
|
Edwards-Bailey A, Ktayen H, Solomou G, Bligh E, Boyle A, Gharooni AA, Lim GHT, Varma A, Standring S, Santarius T, Fountain D. A survey of teaching undergraduate neuroanatomy in the United Kingdom and Ireland. Br J Neurosurg 2021; 36:52-57. [PMID: 33829953 DOI: 10.1080/02688697.2021.1902942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Medical students' perception of neuroanatomy as a challenging topic has implications for referrals and interaction with specialists in the clinical neurosciences. Given plans to introduce a standardised Medical Licensing Assessment by 2023, it is important to understand the current framework of neuroanatomy education. This study aims to describe how neuroanatomy is taught and assessed in the UK and Ireland. METHODS A structured questionnaire capturing data about the timing, methods, materials, assessment and content of the 2019/2020 neuroanatomy curriculum in the UK and Ireland medical schools. RESULTS We received 24/34 responses. Lectures (96%) were the most widely used teaching method, followed by prosection (80%), e-learning (75%), tutorials/seminars (67%), problem-based learning (50%), case-based learning (38%), and dissection (30%). The mean amount of core neuroanatomy teaching was 29.3 hours. The most common formats of assessing neuroanatomical knowledge were multiple-choice exams, spot tests, and objective structured clinical exams. Only 37.5% schools required demonstration of core clinical competency relating to neuroanatomy. CONCLUSIONS Our survey demonstrates variability in how undergraduate neuroanatomy is taught and assessed across the UK and Ireland. There is a role for development and standardisation of national undergraduate neuroanatomy curricula in order to improve confidence and attainment.
Collapse
Affiliation(s)
- Andrew Edwards-Bailey
- Salford Royal Hospital, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Howra Ktayen
- Salford Royal Hospital, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Georgios Solomou
- Keele University School of Medicine, Keele University, Keele, United Kingdom
| | - Emily Bligh
- Faculty of Medicine, Dentistry and Health, University of Sheffield Medical School, Sheffield, United Kingdom
| | - Abbey Boyle
- Leeds School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Aref-Ali Gharooni
- Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Guan Hui Tricia Lim
- University College London Medical School, University College London, London, United Kingdom
| | - Adithya Varma
- Aberdeen Royal Infirmary, University of Aberdeen, Aberdeen, Scotland
| | - Susan Standring
- Department of Anatomy, King's College London, London, United Kingdom
| | - Thomas Santarius
- Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, United Kingdom.,Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Daniel Fountain
- Salford Royal Hospital, Salford Royal NHS Foundation Trust, Manchester, United Kingdom.,Manchester Centre for Clinical Neurosciences, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | | |
Collapse
|
46
|
Bala L, Kinross J, Martin G, Koizia LJ, Kooner AS, Shimshon GJ, Hurkxkens TJ, Pratt PJ, Sam AH. A remote access mixed reality teaching ward round. CLINICAL TEACHER 2021; 18:386-390. [PMID: 33786988 DOI: 10.1111/tct.13338] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/04/2021] [Accepted: 01/12/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Heterogeneous access to clinical learning opportunities and inconsistency in teaching is a common source of dissatisfaction among medical students. This was exacerbated during the COVID-19 pandemic, with limited exposure to patients for clinical teaching. METHODS We conducted a proof-of-concept study at a London teaching hospital using mixed reality (MR) technology (HoloLens2™) to deliver a remote access teaching ward round. RESULTS Students unanimously agreed that use of this technology was enjoyable and provided teaching that was otherwise inaccessible. The majority of participants gave positive feedback on the MR (holographic) content used (n = 8 out of 11) and agreed they could interact with and have their questions answered by the clinician leading the ward round (n = 9). Quantitative and free text feedback from students, patients and faculty members demonstrated that this is a feasible, acceptable and effective method for delivery of clinical education. DISCUSSION We have used this technology in a novel way to transform the delivery of medical education and enable consistent access to high-quality teaching. This can now be integrated across the curriculum and will include remote access to specialist clinics and surgery. A library of bespoke MR educational resources will be created for future generations of medical students and doctors to use on an international scale.
Collapse
Affiliation(s)
- Laksha Bala
- Imperial College School of Medicine, Imperial College London, London, UK
| | - James Kinross
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Guy Martin
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Louis J Koizia
- Cutrale Perioperative and Ageing Group, Imperial College London, London, UK
| | | | | | | | | | - Amir H Sam
- Imperial College School of Medicine, Imperial College London, London, UK
| |
Collapse
|
47
|
Patel N, Costa A, Sanders SP, Ezon D. Stereoscopic virtual reality does not improve knowledge acquisition of congenital heart disease. Int J Cardiovasc Imaging 2021; 37:2283-2290. [PMID: 33677745 DOI: 10.1007/s10554-021-02191-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/09/2021] [Indexed: 11/30/2022]
Abstract
Advances in virtual reality have made it possible for clinicians and trainees to interact with 3D renderings of hearts with congenital heart disease in 3D stereoscopic vision. No study to date has assessed whether this technology improved instruction compared to standard 2D interfaces. The purpose of this study was to assess whether stereoscopic virtual reality improves congenital heart disease anatomy education. Subjects in a prospective, blinded, randomized trial completed a pre-test assessing factual and visuospatial knowledge of common atrioventricular canal and were randomized to an intervention or control group based on their score. The intervention group used a 3D virtual reality (VR) headset to visualize a lecture with 3D heart models while the control group used a desktop (DT) computer interface with the same models. Subjects took a post-test and provided subjective feedback. 51 subjects were enrolled, 24 in the VR group & 27 in the DT group. The median score difference for VR subjects was 12 (IQR 9-13.3), compared to 10 (IQR 7.5-12) in the DT group. No difference in score improvement was found (p = 0.11). VR subjects' impression of the ease of use of their interface was higher than DT subjects (median 8 vs 7, respectively, p = 0.01). VR subjects' impression of their understanding of the subject matter was higher than desktop subjects (median 7 vs 5, respectively, p = 0.01). There was no statistically significant difference in the knowledge acquisition observed between the stereoscopic virtual reality group and the monoscopic desktop-based group. Participants in virtual reality reported a better learning experience and self-assessment suggesting virtual reality may increase learner engagement in understanding congenital heart disease.
Collapse
Affiliation(s)
- Neil Patel
- Icahn School of Medicine at Mount Sinai, Children's Heart Center, Mt. Sinai Hospital, 1 Gustave L Levy Place, Box 1201, New York, NY, 10029, USA
| | - Anthony Costa
- Icahn School of Medicine at Mount Sinai, Children's Heart Center, Mt. Sinai Hospital, 1 Gustave L Levy Place, Box 1201, New York, NY, 10029, USA
| | | | - David Ezon
- Icahn School of Medicine at Mount Sinai, Children's Heart Center, Mt. Sinai Hospital, 1 Gustave L Levy Place, Box 1201, New York, NY, 10029, USA.
| |
Collapse
|
48
|
Bogomolova K, Hierck BP, Looijen AEM, Pilon JNM, Putter H, Wainman B, Hovius SER, van der Hage JA. Stereoscopic three-dimensional visualisation technology in anatomy learning: A meta-analysis. MEDICAL EDUCATION 2021; 55:317-327. [PMID: 32790885 PMCID: PMC7984401 DOI: 10.1111/medu.14352] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 08/04/2020] [Accepted: 08/10/2020] [Indexed: 05/09/2023]
Abstract
OBJECTIVES The features that contribute to the apparent effectiveness of three-dimensional visualisation technology [3DVT] in teaching anatomy are largely unknown. The aim of this study was to conduct a systematic review and meta-analysis of the role of stereopsis in learning anatomy with 3DVT. METHODS The review was conducted and reported according to PRISMA Standards. Literature search of English articles was performed using EMBASE, MEDLINE, CINAHL EBSCOhost, ERIC EBSCOhost, Cochrane CENTRAL, Web of Science and Google Scholar databases until November 2019. Study selection, data extraction and study appraisal were performed independently by two authors. Articles were assessed for methodological quality using the Medical Education Research Study Quality Instrument and the Cochrane Collaboration's tool for assessing the risk of bias. For quantitative analysis, studies were grouped based on relative between-intervention differences in instructional methods and type of control conditions. RESULTS A total of 3934 citations were obtained of which 67 underwent a full-text review. Ultimately, 13 randomised controlled trials were included in the meta-analysis. When interactive, stereoscopic 3D models were compared to interactive, monoscopic 3D models within a single level of instructional design, for example isolating stereopsis as the only true manipulated element in the experimental design, an effect size [ES] of 0.53 (95% confidence interval [CI] 0.26-0.80; P < .00001) was found. In comparison with 2D images within multiple levels of instructional design, an effect size of 0.45 (95% CI 0.10-0.81; P < .002) was found. Stereopsis had no effect on learning when utilised with non-interactive 3D images (ES = -0.87, 95% CI -2.09-0.35; P = .16). CONCLUSION Stereopsis is an important distinguishing element of 3DVT that has a significant positive effect on acquisition of anatomical knowledge when utilised within an interactive 3D environment. A distinction between stereoscopic and monoscopic 3DVT is essential to make in anatomical education and research.
Collapse
Affiliation(s)
- Katerina Bogomolova
- Department of SurgeryFaculty of MedicineLeiden University Medical CenterLeidenThe Netherlands
- Faculty of MedicineCenter for Innovation of Medical EducationLeiden University Medical CenterLeidenThe Netherlands
- Faculty of MedicineInstitute for Medical Education Research RotterdamRotterdam Erasmus University Medical CenterRotterdamThe Netherlands
| | - Beerend P. Hierck
- Faculty of MedicineCenter for Innovation of Medical EducationLeiden University Medical CenterLeidenThe Netherlands
- Department of Anatomy and EmbryologyFaculty of MedicineLeiden University Medical CenterLeidenThe Netherlands
- Leiden Teachers’ AcademyLeiden UniversityLeidenThe Netherlands
- Department of Medical Statistics and BioinformaticsFaculty of MedicineLeiden University Medical CenterLeidenThe Netherlands
| | - Agnes E. M. Looijen
- Faculty of MedicineInstitute for Medical Education Research RotterdamRotterdam Erasmus University Medical CenterRotterdamThe Netherlands
| | - Johanne N. M. Pilon
- Faculty of MedicineInstitute for Medical Education Research RotterdamRotterdam Erasmus University Medical CenterRotterdamThe Netherlands
| | - Hein Putter
- Department of Medical Statistics and BioinformaticsFaculty of MedicineLeiden University Medical CenterLeidenThe Netherlands
| | - Bruce Wainman
- Department of Pathology and Molecular MedicineFaculty of Health SciencesMcMaster UniversityHamiltonONCanada
| | - Steven E. R. Hovius
- Department of Plastic and Reconstructive SurgeryFaculty of MedicineRadboud University Medical CenterNijmegenThe Netherlands
| | - Jos A. van der Hage
- Department of SurgeryFaculty of MedicineLeiden University Medical CenterLeidenThe Netherlands
- Faculty of MedicineCenter for Innovation of Medical EducationLeiden University Medical CenterLeidenThe Netherlands
| |
Collapse
|
49
|
Zingaretti N, Contessi Negrini F, Tel A, Tresoldi MM, Bresadola V, Parodi PC. The Impact of COVID-19 on Plastic Surgery Residency Training. Aesthetic Plast Surg 2020; 44:1381-1385. [PMID: 32458042 PMCID: PMC7250260 DOI: 10.1007/s00266-020-01789-w] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 11/28/2022]
Abstract
Abstract Nowadays didactic and surgical activities for residents in the surgery field are less and less due to an increasing burden of documentation and “non-educational work.” Considering the current lockdown due to the COVID-19 pandemic, it has never been so important to find different ways to allow residents to improve their knowledge. We asked all plastic and esthetic surgery residents in our country to fill out a questionnaire to investigate changes in their didactical activity and analyze problems about their professional growth in the last few months. From the results of such questionnaires, we found that most of the residents feel the decrease in surgical activities during this time is a detrimental factor for their training and that even if all the schools have changed their didactical activities no school has introduced the use of virtual simulators to compensate for the decrease in surgical practice. Actually, the majority of residents use webinars to keep updated, stating that such technologies are useful but not sufficient to analyze plastic surgery topics in depth during COVID-19 lockdown. Virtual interactive tools are well known in different clinical and surgical specialties, and they are considered as a valid support, but it seems that in plastic surgery they are not so used. According to the most recent studies about residents’ didactical program, we have investigated the potential of Anatomage Table in combination with Touch Surgery application as physical and mental aids to bypass the decreased number and kind of surgical interventions performed in this particular time. Anatomage is an academic user-friendly touch screen table; it is used by both medical students and residents to learn human anatomy and to master surgical anatomy. Touch Surgery is an application available on smartphones and tablets that gives the possibility to watch real and virtually designed surgical videos, accompanied by explanatory comments on the surgical phases; they are interactive and give the possibility to check what you have learned through tests administered after virtual classes. In our opinion, these tools represent reliable solutions to improve plastic residents’ training, mostly during the COVID-19 pandemic. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Collapse
|
50
|
Ros M, Debien B, Cyteval C, Molinari N, Gatto F, Lonjon N. Applying an immersive tutorial in virtual reality to learning a new technique. Neurochirurgie 2020; 66:212-218. [PMID: 32623059 DOI: 10.1016/j.neuchi.2020.05.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The medical world is continuously evolving, with techniques being created or improved almost daily. Immersive virtual reality (VR) is a technology that could be harnessed to develop tools that meet the educational challenges of this changing environment. We previously described the immersive tutorial, a 3D video (filmed from the first-person point of view), displayed on a VR application. This tool offers access to supplementary educational data in addition to the video. Here we attempt to assess improvement in learning a technique using this new educational format. MATERIAL AND METHODS We selected a single neurosurgical technique for the study: external ventricular drainage. We wrote a technical note describing this procedure and produced the corresponding immersive tutorial. We conducted a prospective randomized comparative study with students. All participants read the technical note, and one group used the immersive tutorial as a teaching supplement. The students completed a multiple-choice questionnaire immediately after the training and again at six months. RESULTS One hundred seventy-six fourth-year medical students participated in the study; 173 were included in assessing the immediate learning outcomes and 72 were included at the six-month follow-up. The VR group demonstrated significantly better short-term results than the control group (P=0.01). The same trend was seen at six months. CONCLUSION To our knowledge, this study presents one of the largest cohorts for VR. The use of the immersive tutorial could enable a large number of healthcare professionals to be trained without the need for expensive equipment.
Collapse
Affiliation(s)
- M Ros
- Education sciences school - LIRDEF, Montpellier university 3, 2, place Marcel-Godechot, 34000 Montpellier, France.
| | - B Debien
- Medical simulation training center, 641, avenue du Doyen Gaston-Giraud, 34090 Montpellier, France; Montpellier medical school, 2, rue de l'École de Médecine, 34090 Montpellier, France
| | - C Cyteval
- Radiology department, Lapeyronie hospital, 371, avenue du Doyen Gaston-Giraud, 34090 Montpellier, France; Montpellier medical school, 2, rue de l'École de Médecine, 34090 Montpellier, France
| | - N Molinari
- IT medical department, Lapeyronie hospital, 371, avenue du Doyen Gaston-Giraud, 34090 Montpellier, France; Montpellier medical school, 2, rue de l'École de Médecine, 34090 Montpellier, France
| | - F Gatto
- Education sciences school - LIRDEF, Montpellier university 3, 2, place Marcel-Godechot, 34000 Montpellier, France
| | - N Lonjon
- Neurosurgery department, Gui de Chauliac hospital, 80, avenue Augustin-Fliche, 34295 Montpellier, France; Montpellier medical school, 2, rue de l'École de Médecine, 34090 Montpellier, France
| |
Collapse
|