Use of 360° Video for a Virtual Operating Theatre Orientation for Medical Students.
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ABSTRACT: Background
Operating theatres are a unique learning environment that some learners find daunting. By employing orientations some of these fears can be reduced but these require operating theatre space and personnel and are not standardized.Methods
We utilized a 360° camera to generate a "virtual" 360° video orientation. It was filmed in first-person perspective to improve engagement and to make it more experiential.Evaluation
It was shown to 34 medical students in a tutorial setting before their first operating theatre experience. We analyzed their knowledge gain with use of a questionnaire and change in self-reported confidence using a 7-point Likert scale. The students' knowledge improved from 38.4% to 78.2% (p < 0.01) as well as self-reported confidence from 4.3 to 6.1 (p < 0.01).Discussion
The use of 360° video for a virtual operating theatre orientation improved knowledge and confidence of learners which suggests its expanded use in medical education.
SUBMITTER: Fukuta J
PROVIDER: S-EPMC7448883 | biostudies-literature | 2020 Aug
REPOSITORIES: biostudies-literature
Publications
Use of 360° Video for a Virtual Operating Theatre Orientation for Medical Students.
Fukuta Junaid J Gill Nina N Rooney Rebecca R Coombs Alan A Murphy David D
Journal of surgical education 20200826 2
<h4>Background</h4>Operating theatres are a unique learning environment that some learners find daunting. By employing orientations some of these fears can be reduced but these require operating theatre space and personnel and are not standardized.<h4>Methods</h4>We utilized a 360° camera to generate a "virtual" 360° video orientation. It was filmed in first-person perspective to improve engagement and to make it more experiential.<h4>Evaluation</h4>It was shown to 34 medical students in a tutor ...[more]
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Project description:BackgroundVideo-based teaching has been part of medical education for some time but 360° videos using a virtual reality (VR) device are a new medium that offer extended possibilities. We investigated whether adding a 360° VR video to the internship curriculum leads to an improvement of long-term recall of specific knowledge on a gentle Caesarean Sections (gCS) and on general obstetric knowledge.MethodsTwo weeks prior to their Obstetrics and Gynaecology (O&G) internship, medical students were divided in teaching groups, that did or did not have access to a VR-video of a gCS. Six weeks after their O&G internship, potentially having observed one or multiple real-life CSs, knowledge on the gCS was assessed with an open questionnaire, and knowledge on general obstetrics with a multiple-choice questionnaire. Furthermore we assessed experienced anxiety during in-person attendance of CSs, and we asked whether the interns would have wanted to attend more CSs in-person. The 360° VR video group was questioned about their experience directly after they watched the video. We used linear regression analyses to determine significant effects on outcomes.ResultsA total of 89 medical students participated, 41 in the 360° VR video group and 48 in the conventional study group. Watching the 360° VR video did not result in a difference in either specific or general knowledge retention between the intervention group and the conventional study group. This was both true for the grade received for the internship, the open-ended questions as well as the multiple-choice questions and this did not change after adjustment for confounding factors. Still, 83.4% of the 360° VR video-group reported that more videos should be used in training to prepare for surgical procedures. In the 360° VR video-group 56.7% reported side effects like nausea or dizziness. After adjustment for the number of attended CSs during the practical internship, students in the 360° VR video-group stated less often (p = 0.04) that they would have liked to attend more CSs in-person as compared to the conventional study group.ConclusionEven though the use of 360° VR video did not increase knowledge, it did offer a potential alternative for attending a CS in-person and a new way to prepare the students for their first operating room experiences.
| S-EPMC8035054 | biostudies-literature
Project description:BackgroundLearning through a 360° virtual reality (VR) or 2D video represents an alternative way to learn a complex medical education task. However, there is currently no consensus on how best to assess the effects of different learning materials on cognitive load estimates, heart rate variability (HRV), outcomes, and experience in learning history taking and physical examination (H&P) skills.ObjectiveThe aim of this study was to investigate how learning materials (ie, VR or 2D video) impact learning outcomes and experience through changes in cognitive load estimates and HRV for learning H&P skills.MethodsThis pilot system-design study included 32 undergraduate medical students at an academic teaching hospital. The students were randomly assigned, with a 1:1 allocation, to a 360° VR video group or a 2D video group, matched by age, sex, and cognitive style. The contents of both videos were different with regard to visual angle and self-determination. Learning outcomes were evaluated using the Milestone reporting form. Subjective and objective cognitive loads were estimated using the Paas Cognitive Load Scale, the National Aeronautics and Space Administration Task Load Index, and secondary-task reaction time. Cardiac autonomic function was assessed using HRV measurements. Learning experience was assessed using the AttrakDiff2 questionnaire and qualitative feedback. Statistical significance was accepted at a two-sided P value of <.01.ResultsAll 32 participants received the intended intervention. The sample consisted of 20 (63%) males and 12 (38%) females, with a median age of 24 (IQR 23-25) years. The 360° VR video group seemed to have a higher Milestone level than the 2D video group (P=.04). The reaction time at the 10th minute in the 360° VR video group was significantly higher than that in the 2D video group (P<.001). Multiple logistic regression models of the overall cohort showed that the 360° VR video module was independently and positively associated with a reaction time at the 10th minute of ≥3.6 seconds (exp B=18.8, 95% CI 3.2-110.8; P=.001) and a Milestone level of ≥3 (exp B=15.0, 95% CI 2.3-99.6; P=.005). However, a reaction time at the 10th minute of ≥3.6 seconds was not related to a Milestone level of ≥3. A low-frequency to high-frequency ratio between the 5th and 10th minute of ≥1.43 seemed to be inversely associated with a hedonic stimulation score of ≥2.0 (exp B=0.14, 95% CI 0.03-0.68; P=.015) after adjusting for video module. The main qualitative feedback indicated that the 360° VR video module was fun but caused mild dizziness, whereas the 2D video module was easy to follow but tedious.ConclusionsOur preliminary results showed that 360° VR video learning may be associated with a better Milestone level than 2D video learning, and that this did not seem to be related to cognitive load estimates or HRV indexes in the novice learners. Of note, an increase in sympathovagal balance may have been associated with a lower hedonic stimulation score, which may have met the learners' needs and prompted learning through the different video modules.Trial registrationClinicalTrials.gov NCT03501641; https://clinicaltrials.gov/ct2/show/NCT03501641.
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Project description:Historically, medical trainees were educated in the hospital on real patients. Over the last decade, there has been a shift to practicing skills through simulations with mannequins or patient actors. Virtual reality (VR), and in particular, the use of 360-degree video and audio (cineVR), is the next-generation advancement in medical simulation that has novel applications to augment clinical skill practice, empathy building, and team training. In this paper, we describe methods to design and develop a cineVR medical education curriculum for trauma care training using real patient care scenarios at an urban, safety-net hospital and Level 1 trauma center. The purpose of this publication is to detail the process of finding a cineVR production partner; choosing the camera perspectives; maintaining patient, provider, and staff privacy; ensuring data security; executing the cineVR production process; and building the curriculum.
| S-EPMC7773512 | biostudies-literature
Project description:Introduction:The operating room is a complex environment in which individual team members perform specific tasks according to their role. A simulation activity was created to introduce medical students on the surgery clerkship to issues relating to patient safety, infection control, and regulatory requirements. Methods:This activity takes place prior to general surgery rotation operative experiences, and addresses the need for students to practice roles they will perform while participating in patient care. The activity includes a simulated operation, an assessment, and a scripted debriefing. Among other tasks, students practice safe patient transfer and monitoring, donning sterile garb, preparing the surgical site, and being active participants in a sign-in and time-out. Students are assessed on assigned tasks, their ability to maintain sterility, and the degree to which they engage with their team. Results:Students reported the simulation helped them better understand how they could become involved on their first day in the operating room. Students also reported they were more confident when in the operating room. This finding also extended to students who had previously been in the operating room during a prior OB/GYN rotation. Discussion:Patient safety is paramount when in the operating room, and this simulation activity fills a current gap in student's practical knowledge as they prepare to enter their surgery clerkship. Giving medical students the information and skills needed to be safe and effective members of the operating team prior to entering the operating room is of benefit to the surgical team, students, and patients.
| S-EPMC6338138 | biostudies-literature
Project description:ObjectivesThe need for remote delivery of mental health interventions including instruction in meditation has become paramount in the wake of the current global pandemic. However, the support one may usually feel within the physical presence of an instructor may be weakened when interventions are delivered remotely, potentially impacting one's meditative experiences. Use of head-mounted displays (HMD) to display video-recorded instruction may increase one's sense of psychological presence with the instructor as compared to presentation via regular flatscreen (e.g., laptop) monitor. This research therefore evaluated a didactic, trauma-informed care approach to instruction in mindfulness meditation by comparing meditative responses to an instructor-guided meditation when delivered face-to-face vs. by pre-recorded 360° videos viewed either on a standard flatscreen monitor (2D format) or via HMD (i.e., virtual reality [VR] headset; 3D format).MethodsYoung adults (n = 82) were recruited from a university introductory course and experienced a 360° video-guided meditation via HMD (VR condition, 3D format). They were also randomly assigned to practice the same meditation either via scripted face-to-face instruction (in vivo [IV] format) or when viewed on a standard laptop display (non-VR condition, 2D format). Positive and negative affect and meditative experience ratings were self-reported and participants' maintenance of focused attention to breathing (i.e., meditation breath attention scores [MBAS]) were recorded during each meditation.ResultsMeditating in VR (3D format) was associated with a heightened experience of awe overall. When compared to face-to-face instruction (IV format), VR meditation was rated as less embarrassing but also less enjoyable and more tiring. When compared to 2D format, VR meditations were associated with greater experiences of relaxation, less distractibility from the process of breathing, and less fatigue. No differences were found between VR and non-VR meditation in concentration (MBAS). Baseline posttraumatic stress symptoms were risk factors for experiencing distress while meditating in either (VR and non-VR) instructional format. Of those who reported a preference for one format, approximately half preferred the VR format and approximately half preferred the IV format.ConclusionsRecorded 360° video instruction in meditation viewed with a HMD (i.e., VR/3D format) appears to offer some experiential advantage over instructions given in 2D format and may offer a safe-and for some even preferred-alternative to teaching meditation face-to-face.Supplementary informationThe online version contains supplementary material available at 10.1007/s12671-021-01612-w.
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Project description:Several studies have reported on the negative impact of interruptions and distractions on anaesthetic, surgical and team performance in the operating theatre. This study aimed to gain a deeper understanding of these events and why they remain part of everyday clinical practice. We used a mixed methods observational study design. We scored each distractor and interruption according to an established scheme during induction of anaesthesia and the surgical procedure for 58 general surgical cases requiring general anaesthesia. We made field notes of observations, small conversations and meetings. We observed 64 members of staff for 148 hours and recorded 4594 events, giving a mean (SD) event rate of 32.8 (16.3) h-1 . The most frequent events observed during induction of anaesthesia were door movements, which accounted for 869 (63%) events, giving a mean (SD) event rate of 28.1 (14.5) h-1 . These, however, had little impact. The most common events observed during surgery were case-irrelevant verbal communication and smartphone usage, which accounted for 1020 (32%) events, giving a mean (SD) event rate of 9.0 (4.2) h-1 . These occurred mostly in periods of low work-load in a sub-team. Participants ranged from experiencing these events as severe disruption through to a welcome distraction that served to keep healthcare professionals active during low work-load, as well as reinforcing the social connections between colleagues. Mostly, team members showed no awareness of the need for silence among other sub-teams and did not vocalise the need for silence to others. Case-irrelevant verbal communication and smartphone usage may serve a physical and psychological need. The extent to which healthcare professionals may feel disrupted depends on the situation and context. When a team member was disrupted, a resilient team response often lacked. Reducing disruptive social activity might be a powerful strategy to develop a habit of cross-monitoring and mutual help across surgical and anaesthetic sub-teams. Further research is needed on how to bridge cultural borders and develop resilient interprofessional behaviours.
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Project description:Improved surgical outcome and patient safety in the operating theatre are constant challenges. We hypothesise that a framework that collects and utilises information -especially perceptually enabled ones-from multiple sources, could help to meet the above goals. This paper presents some core functionalities of a wider low-cost framework under development that allows perceptually enabled interaction within the surgical environment.The synergy of wearable eye-tracking and advanced computer vision methodologies, such as SLAM, is exploited. As a demonstration of one of the framework's possible functionalities, an articulated collaborative robotic arm and laser pointer is integrated and the set-up is used to project the surgeon's fixation point in 3D space.The implementation is evaluated over 60 fixations on predefined targets, with distances between the subject and the targets of 92-212 cm and between the robot and the targets of 42-193 cm. The median overall system error is currently 3.98 cm. Its real-time potential is also highlighted.The work presented here represents an introduction and preliminary experimental validation of core functionalities of a larger framework under development. The proposed framework is geared towards a safer and more efficient surgical theatre.
| S-EPMC5509830 | biostudies-other
Project description:Collaborative reasoning occurs in clinical practice but is rarely developed during education. The computerized virtual patient (VP) cases allow for a stepwise exploration of cases and thus stimulate active learning. Peer settings during VP sessions are believed to have benefits in terms of reasoning but have received scant attention in the literature.The objective of this study was to thoroughly investigate interactions during medical students' clinical reasoning in two-party VP settings.An in-depth exploration of students' interactions in dyad settings of VP sessions was performed. For this purpose, two prerecorded VP sessions lasting 1 hour each were observed, transcribed in full, and analyzed. The transcriptions were analyzed using thematic analysis, and short clips from the videos were selected for subsequent analysis in relation to clinical reasoning and clinical aspects.Four categories of interactions were identified: (1) task-related dialogue, in which students negotiated a shared understanding of the task and strategies for information gathering; (2) case-related insights and perspectives were gained, and the students consolidated and applied preexisting biomedical knowledge into a clinical setting; (3) clinical reasoning interactions were made explicit. In these, hypotheses were followed up and clinical examples were used. The researchers observed interactions not only between students and the VP but also (4) interactions with other resources, such as textbooks. The interactions are discussed in relation to theories of clinical reasoning and peer learning.The dyad VP setting is conducive to activities that promote analytic clinical reasoning. In this setting, components such as peer interaction, access to different resources, and reduced time constraints provided a productive situation in which the students pursued different lines of reasoning.
| S-EPMC5849799 | biostudies-other
Project description:IntroductionThe COVID-19 pandemic presented unique challenges to medical student education. Medical student activities involving direct patient contact were limited, challenging anesthesiology programs to develop innovative means of presenting a clinical experience to trainees. In response, the Department of Anesthesiology at the University of Minnesota Medical School quickly transitioned its introductory anesthesiology clerkship to be entirely virtual. We designed the resulting curriculum to provide medical students with the most experiential learning experience possible.MethodsWe created and conducted a virtual curriculum for medical students that incorporated video-recorded simulation-based scenarios to facilitate case-based learning discussions (CBLDs). At the end of their 2-week rotation, students completed a postclerkship survey with Likert-scale questions and an open-ended question intended to elicit feedback and evaluate the efficacy of the virtual curriculum.ResultsTwenty-eight medical students finished the 2-week virtual anesthesiology clerkship over eight blocks, with all 28 students completing the postclerkship survey. Survey responses demonstrated that the virtual clerkship met or exceeded expectations in all areas. A majority of students (74%, 14 of the 19 who answered the associated question) felt that the faculty-led CBLD exercises were informative. All 28 students agreed or strongly agreed that the virtual assignments were valuable and facilitated learning.DiscussionWe successfully implemented a virtual anesthesiology clerkship curriculum in response to constraints presented by the COVID-19 pandemic. The virtual format provides trainees with a simulated clinical experience that can be utilized not only during future pandemics but also in modern training curricula.
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Project description:COVID-19 patients in the critical care unit tend to have prolonged hospital stay requiring high doses of sedation and paralysis to treat acute respiratory distress syndrome, resulting in a shortage of these drugs. In our hospital, we have instituted strategies to rationalise drug and oxygen usage. This includes prioritising time-sensitive elective cases, reducing overall elective case load, favouring opioid-reduction strategies and usage of alternative anaesthetic agents not commonly used in ICU. Both intensive care physicians and anaesthesiologists have to cooperate on drug conservation as similar drugs are used in elective operating lists as in the ICU. Patient safety is of utmost importance and we should keep in mind some pitfalls and ethical concerns of these alternative strategies.
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