scholarly journals Mixed reality for teaching catheter placement to medical students: a randomized single-blinded, prospective trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
D. S. Schoeb ◽  
J. Schwarz ◽  
S. Hein ◽  
D. Schlager ◽  
P. F. Pohlmann ◽  
...  
Keyword(s):  
Medical Students ◽  
Mixed Reality ◽  
Prospective Trial ◽  
Learning Outcome ◽  
Catheter Placement ◽  
Guidance System ◽  
Control Group ◽  
Medical Procedure ◽  
Bladder Catheter ◽  
Mr Guidance

Abstract Background Cost-effective methods to facilitate practical medical education are in high demand and the “mixed-reality” (MR) technology seems suitable to provide students with instructions when learning a new practical task. To evaluate a step-by-step mixed reality (MR) guidance system for instructing a practical medical procedure, we conducted a randomized, single-blinded prospective trial on medical students learning bladder catheter placement. Methods We enrolled 164 medical students. Students were randomized into 2 groups and received instructions on how to perform bladder catheter placement on a male catheterization training model. One group (107 students) were given their instructions by an instructor, while the other group (57 students) were instructed via an MR guidance system using a Microsoft HoloLens. Both groups did hands on training. A standardized questionnaire covering previous knowledge, interest in modern technologies and a self-evaluation was filled out. In addition, students were asked to evaluate the system’s usability. We assessed both groups’s learning outcome via a standardized OSCE (objective structured clinical examination). Results Our evaluation of the learning outcome revealed an average point value of 19.96 ± 2,42 for the control group and 21.49 ± 2.27 for the MR group - the MR group’s result was significantly better (p = 0.00). The self-evaluations revealed no difference between groups, however, the control group gave higher ratings when evaluating the quality of instructions. The MR system’s assessment showed less usability, with a cumulative SUS (system usability scale) score of 56.6 (lower half) as well as a cumulative score of 24.2 ± 7.3 (n = 52) out of 100 in the NASA task load index. Conclusions MR is a promising tool for instructing practical skills, and has the potential to enable superior learning outcomes. Advances in MR technology are necessary to improve the usability of current systems. Trial registration German Clinical Trial Register ID: DRKS00013186

scholarly journals Comparison of the effectiveness of lecture instruction and virtual reality-based serious gaming instruction on the medical students’ learning outcome about approach to coma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meysam Siyah Mansoory ◽  
Mohammad Rasool Khazaei ◽  
Seyyed Mohsen Azizi ◽  
Elham Niromand
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Learning Outcomes ◽  
Learning Outcome ◽  
Serious Game ◽  
Control Group ◽  
Serious Gaming ◽  
E Learning ◽  
The Mean ◽  
Lecture Instruction

Abstract Background New approaches to e-learning and the use of virtual reality technology and serious game in medical education are on the rise. Therefore, the purpose of this study was to compare the effectiveness of lecture method and virtual reality-based serious gaming (VRBSG) method on students learning outcomes about the approach to coma. Methods We adopted a randomized trial method for this study and selected 50 medical students dividing them into experimental and control groups. Students’ learning outcome was measured with a 10-item test. Serious game usability scale was used to evaluate the usability of the serious game. Descriptive and inferential statistics were used for data analysis by SPSS-22 software. Results Students’ familiarity with e-learning and VRBSG was low. The mean usability of a VRBSG was 126.78 ± 10.34 out of 150. The majority of students were eager to be instructed through VRBSG. The mean score of learning outcomes in the experimental group was significantly higher than the control group (t = − 2.457, P = 0.019). Conclusion Students’ learning outcomes in the VRBSG group in the test approach to coma were significantly better than the lecture group. The usability of the serious game instruction method was high. Taken together, instruction through VRBSG had an effective role in medical students’ learning.

scholarly journals Effect of an Augmented Reality Ultrasound Trainer App on the Motor Skills Needed for a Kidney Ultrasound: Prospective Trial (Preprint)

2018 ◽  
Author(s):  
Florian Ebner ◽  
Amelie De Gregorio ◽  
Fabienne Schochter ◽  
Inga Bekes ◽  
Wolfgang Janni ◽  
...  
Keyword(s):  
Medical Students ◽  
Augmented Reality ◽  
Left Kidney ◽  
Prospective Trial ◽  
Learning By Doing ◽  
Mobile App ◽  
Control Group ◽  
Study Group ◽  
Educational Training ◽  
Significant Difference

BACKGROUND Medical education is evolving from "learning by doing" to simulation-based hands-on tutorials. OBJECTIVE The aim of this prospective 2-armed study was to evaluate a newly developed augmented reality ultrasound app and its effect on educational training and diagnostic accuracy. METHODS We recruited 66 medical students and, using imaging and measuring a kidney as quality indicators, tested them on the time they needed for these tasks. Both groups used textbooks as preparation; in addition, the study group had access to a virtual ultrasound simulation app for mobile devices. RESULTS There was no significant difference between the study arms regarding age (P=.97), sex (P=.14), and previous ultrasound experience (P=.66). The time needed to complete the kidney measurements also did not differ significantly (P=.26). However, the results of the longitudinal kidney measurements differed significantly between the study and control groups, with larger, more realistic values in the study group (right kidney: study group median 105.3 mm, range 86.1-127.1 mm, control group median 92 mm, range 50.4-112.2 mm; P<.001; left kidney: study group median 100.3 mm, range 81.7-118.6 mm, control group median 85.3 mm, range 48.3-113.4 mm; P<.001). Furthermore, whereas all students of the study group obtained valid measurements, students of the control group did not obtain valid measurements of 1 or both kidneys in 7 cases. CONCLUSIONS The newly developed augmented reality ultrasound simulator mobile app provides a useful add-on for ultrasound education and training. Our results indicate that medical students’ use of the mobile app for training purposes improved the quality of kidney measurements.

Effect of tunneled and nontunneled peripherally inserted central catheter placement: A randomized controlled trial

2019 ◽  
Vol 21 (4) ◽  
pp. 511-519
Author(s):  
Can Dai ◽  
Jia Li ◽  
Qiu-mei Li ◽  
Xiuquan Guo ◽  
Yu-ying Fan ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Controlled Trial ◽  
Prospective Trial ◽  
Catheter Placement ◽  
Control Group ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Randomized Controlled ◽  
Catheter Dislodgement ◽  
Experimental Group

Purpose: To compare the effect of tunneled and nontunneled peripherally inserted central catheter placement under B-mode ultrasound. Methods: A single center, randomized, controlled, nonblinded, prospective trial was conducted in Guangzhou, China, between July 2018 and May 2019. A total of 174 participants were randomized to the experimental group (tunneled peripherally inserted central catheter) or the control group (nontunneled peripherally inserted central catheter) and were followed until extubation. Basic characteristics, peripherally inserted central catheter characteristics, the incidence of complications, and the costs of peripherally inserted central catheter placement and maintenance were collected. Data were analyzed by intention-to-treat. Results: A total of 168 of the participants had successful peripherally inserted central catheter placements (85/87, 97.7% in the experimental group and 83/87, 95.4% in the control group, P = 0.682). Compared to the control group, the experimental group had a lower incidence of complications during the placement (18.4% vs 32.2%, P = 0.036), a lower incidence of wound oozing (27.6% vs 57.5%, P < 0.001), a lower incidence of medical adhesive–related skin injury (9.2% vs 25.3%, P = 0.005), a lower incidence of venous thrombosis (1.1% vs 9.2%, P = 0.034), a lower incidence of catheter dislodgement (1.1% vs 9.2%, P = 0.034), and lower costs of peripherally inserted central catheter maintenance at 1, 2, and 3 months ( P < 0.05). Conclusion: Tunneled peripherally inserted central catheter may be recommended for good effectiveness.

scholarly journals Towards a First-Person Perspective Mixed Reality Guidance System for Needle Interventions

2022 ◽  
Vol 8 (1) ◽  
pp. 7
Author(s):  
Leah Groves ◽  
Natalie Li ◽  
Terry M. Peters ◽  
Elvis C. S. Chen
Keyword(s):  
Medical Students ◽  
User Study ◽  
Mixed Reality ◽  
Surgical Navigation ◽  
Guidance System ◽  
Complication Rates ◽  
Success Rates ◽  
Head Mounted Display ◽  
Us Guidance ◽  
Significant Difference

While ultrasound (US) guidance has been used during central venous catheterization to reduce complications, including the puncturing of arteries, the rate of such problems remains non-negligible. To further reduce complication rates, mixed-reality systems have been proposed as part of the user interface for such procedures. We demonstrate the use of a surgical navigation system that renders a calibrated US image, and the needle and its trajectory, in a common frame of reference. We compare the effectiveness of this system, whereby images are rendered on a planar monitor and within a head-mounted display (HMD), to the standard-of-care US-only approach, via a phantom-based user study that recruited 31 expert clinicians and 20 medical students. These users performed needle-insertions into a phantom under the three modes of visualization. The success rates were significantly improved under HMD-guidance as compared to US-guidance, for both expert clinicians (94% vs. 70%) and medical students (70% vs. 25%). Users more consistently positioned their needle closer to the center of the vessel’s lumen under HMD-guidance compared to US-guidance. The performance of the clinicians when interacting with this monitor system was comparable to using US-only guidance, with no significant difference being observed across any metrics. The results suggest that the use of an HMD to align the clinician’s visual and motor fields promotes successful needle guidance, highlighting the importance of continued HMD-guidance research.

scholarly journals Efficacy of implementing intermittent STOP THE BLEED® reviews on long term retention of hemorrhage control skills of first year medical students

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Enkhtsogt Sainbayar ◽  
Nathan Holt ◽  
Amber Jacobson ◽  
Shalini Bhatia ◽  
Christina Weaver
Keyword(s):  
Medical Students ◽  
Intervention Group ◽  
Training Session ◽  
Likert Scale ◽  
Control Group ◽  
First Year ◽  
Hemorrhage Control ◽  
Term Retention ◽  
Long Term Retention

Abstract Context Some medical schools integrate STOP THE BLEED® training into their curricula to teach students how to identify and stop life threatening bleeds; these classes that are taught as single day didactic and hands-on training sessions without posttraining reviews. To improve retention and confidence in hemorrhage control, additional review opportunities are necessary. Objectives To investigate whether intermittent STOP THE BLEED® reviews were effective for long term retention of hemorrhage control skills and improving perceived confidence. Methods First year osteopathic medical students were asked to complete an eight item survey (five Likert scale and three quiz format questions) before (pretraining) and after (posttraining) completing a STOP THE BLEED® training session. After the surveys were collected, students were randomly assigned to one of two study groups. Over a 12 week intervention period, each group watched a 4 min STOP THE BLEED® review video (intervention group) or a “distractor” video (control group) at 4 week intervals. After the 12 weeks, the students were asked to complete an 11 item survey. Results Scores on the posttraining survey were higher than the pretraining survey. The median score on the five Likert scale items was 23 points for the posttraining survey and 14 points for the pretraining survey. Two of the three knowledge based quiz format questions significantly improved from pretraining to posttraining (both p<0.001). On the 11 item postintervention survey, both groups performed similarly on the three quiz questions (all p>0.18), but the intervention group had much higher scores on the Likert scale items than the control group regarding their confidence in their ability to identify and control bleeding (intervention group median = 21.4 points vs. control group median = 16.8 points). Conclusions Intermittent review videos for STOP THE BLEED® training improved medical students’ confidence in their hemorrhage control skills, but the videos did not improve their ability to correctly answer quiz-format questions compared with the control group.

scholarly journals Combined low-dose everolimus and low-dose tacrolimus after Alemtuzumab induction therapy: a randomized prospective trial in lung transplantation

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alberto Benazzo ◽  
Ara Cho ◽  
Anna Nechay ◽  
Stefan Schwarz ◽  
Florian Frommlet ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Lung Transplantation ◽  
Kidney Function ◽  
Induction Therapy ◽  
Low Dose ◽  
Prospective Trial ◽  
Control Group ◽  
Long Term Outcomes ◽  
Maintenance Immunosuppression

Abstract Background Long-term outcomes of lung transplantation are severely affected by comorbidities and development of chronic rejection. Among the comorbidities, kidney insufficiency is one of the most frequent and it is mainly caused by the cumulative effect of calcineurin inhibitors (CNIs). Currently, the most used immunosuppression protocols worldwide include induction therapy and a triple-drug maintenance immunosuppression, with one calcineurin inhibitor, one anti-proliferative drug, and steroids. Our center has pioneered the use of alemtuzumab as induction therapy, showing promising results in terms of short- and long-term outcomes. The use of alemtuzumab followed by a low-dose double drug maintenance immunosuppression, in fact, led to better kidney function along with excellent results in terms of acute rejection, chronic lung allograft dysfunction, and survival (Benazzo et al., PLoS One 14(1):e0210443, 2019). The hypothesis driving the proposed clinical trial is that de novo introduction of low-dose everolimus early after transplantation could further improve kidney function via a further reduction of tacrolimus. Based on evidences from kidney transplantation, moreover, alemtuzumab induction therapy followed by a low-dose everolimus and low-dose tacrolimus may have a permissive action on regulatory immune cells thus stimulating allograft acceptance. Methods A randomized prospective clinical trial has been set up to answer the research hypothesis. One hundred ten patients will be randomized in two groups. Treatment group will receive the new maintenance immunosuppression protocol based on low-dose tacrolimus and low-dose everolimus and the control group will receive our standard immunosuppression protocol. Both groups will receive alemtuzumab induction therapy. The primary endpoint of the study is to analyze the effect of the new low-dose immunosuppression protocol on kidney function in terms of eGFR change. The study will have a duration of 24 months from the time of randomization. Immunomodulatory status of the patients will be assessed with flow cytometry and gene expression analysis. Discussion For the first time in the field of lung transplantation, this trial proposes the combined use of significantly reduced tacrolimus and everolimus after alemtuzumab induction. The new protocol may have a twofold advantage: (1) further reduction of nephrotoxic tacrolimus and (2) permissive influence on regulatory cells development with further reduction of rejection episodes. Trial registration EUDRACT Nr 2018-001680-24. Registered on 15 May 2018

scholarly journals Association of ocular blood flow and contrast sensitivity in normal tension glaucoma

2021 ◽  
Author(s):  
David Kuerten ◽  
Matthias Fuest ◽  
Peter Walter ◽  
Babac Mazinani ◽  
Niklas Plange
Keyword(s):  
Blood Flow ◽  
Visual Field ◽  
Contrast Sensitivity ◽  
Visual Field Defect ◽  
Prospective Trial ◽  
Normal Tension Glaucoma ◽  
Ocular Blood Flow ◽  
Retinal Blood Flow ◽  
Control Group ◽  
Field Defect

Abstract Purpose To investigate the relationship of ocular blood flow (via arteriovenous passage time, AVP) and contrast sensitivity (CS) in healthy as well as normal tension glaucoma (NTG) subjects. Design Mono-center comparative prospective trial Methods Twenty-five NTG patients without medication and 25 healthy test participants were recruited. AVP as a measure of retinal blood flow was recorded via fluorescein angiography after CS measurement using digital image analysis. Association of AVP and CS at 4 spatial frequencies (3, 6, 12, and 18 cycles per degree, cpd) was explored with correlation analysis. Results Significant differences regarding AVP, visual field defect, intraocular pressure, and CS measurement were recorded in-between the control group and NTG patients. In NTG patients, AVP was significantly correlated to CS at all investigated cpd (3 cpd: r =  − 0.432, p< 0.03; 6 cpd: r =  − 0.629, p< 0.0005; 12 cpd: r =  − 0.535, p< 0.005; and 18 cpd: r =  − 0.58, p< 0.001), whereas no significant correlations were found in the control group. Visual acuity was significantly correlated to CS at 6, 12, and 18 cpd in NTG patients (r =  − 0.68, p< 0.002; r =  − 0.54, p< .02, and r =  − 0.88, p< 0.0001 respectively), however not in healthy control patients. Age, visual field defect MD, and PSD were not significantly correlated to CS in in the NTG group. MD and PSD were significantly correlated to CS at 3 cpd in healthy eyes (r = 0.55, p< 0.02; r =  − 0.47, p< 0.03). Conclusion Retinal blood flow alterations show a relationship with contrast sensitivity loss in NTG patients. This might reflect a disease-related link between retinal blood flow and visual function. This association was not recorded in healthy volunteers.

scholarly journals Evaluating the effectiveness of a single-day simulation-based program in psychiatry for medical students: a controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia Younes ◽  
Anne Laure Delaunay ◽  
M. Roger ◽  
Pierre Serra ◽  
France Hirot ◽  
...  
Keyword(s):  
Medical Students ◽  
Factor Structure ◽  
Internal Consistency ◽  
Controlled Study ◽  
Simulated Patients ◽  
Control Group ◽  
Retest Reliability ◽  
Knowledge And Attitudes ◽  
Simulation Group ◽  
Test Retest Reliability

Abstract Background Training in psychiatry requires specific knowledge, attitudes, and skills that are obtainable by simulation, of which the use is only recent and still needs further development. Evidence is accumulating on its effectiveness but requires further validation for medical students. We aimed to evaluate the effectiveness of a single-day optional teaching program in psychiatry by simulation for medical students and validate a scale measuring Confidence in Psychiatric Clinical Skills (CPCQ), as part of the assessment. Methods This was a controlled study in a French University that compared (using paired-sample Student t-tests) knowledge and attitudes (university grades and CPCQ scores) before, just after teaching with simulated patients, and 2 months later. Satisfaction with the program (including the quality of the debriefing) was also investigated. The CPCQ scale was validated by assessing the factor structure, internal consistency, and test-retest reliability. Finally, a comparison was run with a control group who received the usual psychiatric instruction using covariance analyses. Results Twenty-four medical students were included in the simulation group and 76 in the control group. Just after the simulation, knowledge and attitudes increased significantly in the simulation group. Satisfaction with the training and debriefing was very high. The CPCQ scale showed good psychometric properties: a single-factor structure, acceptable internal consistency (α = 0.73 [0.65–0.85]), and good test-retest reliability (ICC = 0.71 [0.35–0.88]). Two months after the simulation, knowledge and attitudes were significantly higher in the simulation group than the control group, despite a lack of difference in knowledge before the simulation. Conclusions Adding a simulation program in psychiatry to the usual teaching improved the knowledge and confidence of medical students. The CPCQ scale could be used for the evaluation of educational programs.

scholarly journals The impact of mediated learning on the academic writing performance of medical students in flipped and traditional classrooms: scaffolding techniques

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Laleh Khojasteh ◽  
Seyyed Ali Hosseini ◽  
Elham Nasiri
Keyword(s):  
Medical Students ◽  
Academic Writing ◽  
Flipped Classroom ◽  
Second Language Learners ◽  
Control Group ◽  
Mediated Learning ◽  
Writing Classes ◽  
Writing Group ◽  
The Impact ◽  
Experimental Group

AbstractWriting as a multiple-step process is one of the most complex and demanding skills for graduate students to master. Foreign or second language learners who are required to write for academic purposes at the university level may even find it more demanding to master. One of the ways of decreasing the burden of mastering this skill for learners is mediation, using scaffolding techniques to teach writing. Hence, having a good understanding of the impact(s) of adopting mediating or scaffolding techniques in writing classes is absolutely indispensable. To this end, the present study employed an experimental research design to investigate the impact of mediation in the flipped writing classrooms of the students of medicine. To peruse this goal, 47 medical students were selected through purposive sampling and put into control and treatment groups. Medical students in the treatment group watched teacher-made video content(s) before their writing classes. The students in this group experienced organized-interactive writing group activities in their classes. Unlike the experimental group, the students in the control group received all the instructions in the classroom and were assigned homework. The findings obtained through the ANOVA and t-test indicated that the students in the experimental group significantly outperformed their counterparts in the control group in terms of their writing. A probable conclusion could be that by requiring students to study in advance and take responsibility for their learning, flipped classroom can provide the opportunity for learners to actively construct knowledge rather than receive the information passively in the classroom. Flipped classroom can also cultivate interactive class time for teachers and enable them to invest in more fruitful academic practices, instead of asking students to spend a substantial amount of time each week doing homework independently.

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