Embedding a Virtual Patient Simulator in an Interactive Surgical lecture.

BACKGROUND Lectures are traditionally used for teaching declarative knowledge. One established tool for clinical education is the demonstration of a real patient. The use of real patients in the daily clinical environment is increasingly difficult. The use of a virtual patient simulator (VPS) can potentially circumvent these problems. Unlimited availability and the opportunity of an electronic feedback system could possibly enrich traditional lectures by enabling more interactivity that meets the expectations of the current student generation. As students face the consequences of their own decisions they take a more active role in the lecture. VPS links declarative knowledge with visual perception that is known to influence students' motivation. Until now, there have been no reports covering the usage and validation of interactive VPS for supporting traditional lectures. AIM In this study, we (1) described the development of a custom-made three-dimensional (3D) VPS for supporting the traditional lecture and (2) performed a feasibility study including an initial assessment of this novel educational concept. METHODS Conceptualization included definition of curricular content, technical realization and validation. A custom-made simulator was validated with 68 students. The degree of student acceptance was evaluated. Furthermore, the effect on knowledge gain was determined by testing prelecture and postlecture performance. RESULTS A custom-made simulator prototype that displays a 3D virtual clinic environment was developed and linked to a PowerPoint presentation. Students were able to connect to the simulator via electronic devices (smartphones and tablets) and to control the simulator via majority vote. The simulator was used in 6 lectures and validated in 2 lectures with 68 students each. Student acceptance and their opinion about effectiveness and applicability were determined. Students showed a high level of motivation when using the simulator as most of them had fun using it. Effect on knowledge gain was proven by comparison of chosen therapeutic workflow before and after the lecture. Students showed significantly (p < 0.05) more correct answers in determination of the therapeutic workflow after the lecture. CONCLUSIONS We successfully developed and evaluated a custom-made 3D VPS for supporting the traditional lecture. VPS is probably an effective instrument that might replace real patients in selected lectures and prepare students for bedside teaching.

[1]  Matthew D. Timberlake,et al.  Novel educational approach for medical students: improved retention rates using interactive medical software compared with traditional lecture-based format. , 2012, Journal of surgical education.

[2]  Deborah Allen,et al.  Approaches to biology teaching and learning: understanding the wrong answers--teaching toward conceptual change. , 2005, Cell biology education.

[3]  Lisa L. Schlitzkus,et al.  Is your residency program ready for Generation Y? , 2010, Journal of surgical education.

[4]  R. Kim,et al.  Learning style preferences of surgical residency applicants. , 2015, The Journal of surgical research.

[5]  Robert Kleinert,et al.  3D Immersive Patient Simulators and Their Impact on Learning Success: A Thematic Review , 2015, Journal of medical Internet research.

[6]  Einrichtung eines chirurgischen Trainingslabors an einer Ausbildungsklinik , 2006, Der Chirurg.

[7]  Heidi S Chumley-Jones,et al.  Web‐based Learning: Sound Educational Method or Hype? A Review of the Evaluation Literature , 2002, Academic medicine : journal of the Association of American Medical Colleges.

[8]  J. J. Jakimowicz,et al.  Consensus guidelines for validation of virtual reality surgical simulators , 2005, Surgical Endoscopy And Other Interventional Techniques.

[9]  Jodie Eckleberry-Hunt,et al.  The challenges and opportunities of teaching "generation y". , 2011, Journal of Graduate Medical Education.

[10]  E. Marcus Empathy, humanism, and the professionalization process of medical education. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[11]  A. Muijtjens,et al.  Impact of institute and person variables on teachers’ conceptions of learning and teaching* , 2015, Medical teacher.

[12]  Z. Fatmi,et al.  Problem-Based Versus Conventional Curricula: Influence on Knowledge and Attitudes of Medical Students Towards Health Research , 2007, PloS one.

[13]  D. Cook,et al.  Computerized Virtual Patients in Health Professions Education: A Systematic Review and Meta-Analysis , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[14]  Christine M. Yukech,et al.  Puzzle-based versus traditional lecture: comparing the effects of pedagogy on academic performance in an undergraduate human anatomy and physiology II lab , 2015, BMC medical education.

[15]  B. Blatt,et al.  Perspective: successfully negotiating the clerkship years of medical school: a guide for medical students, implications for residents and faculty. , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[16]  Magy Seif El-Nasr,et al.  Methods for Game User Research: Studying Player Behavior to Enhance Game Design , 2013, IEEE Computer Graphics and Applications.

[17]  A. Hölscher,et al.  Präoperative Erfassung von Prognosefaktoren beim Plattenepithelkarzinom des Ösophagus , 2005, Der Chirurg.

[18]  Veerasathpurush Allareddy,et al.  Weakest students benefit most from a customized educational experience for Generation Y students , 2014, PeerJ.

[19]  Bernd Blobel,et al.  The New Role of Patients in Future Health Settings , 2015, pHealth.

[20]  Robert Kleinert,et al.  Design, Realization, and First Validation of an Immersive Web-Based Virtual Patient Simulator for Training Clinical Decisions in Surgery. , 2015, Journal of surgical education.

[21]  T. Lanciano,et al.  Emotions in the classroom: the role of teachers' emotional intelligence ability in predicting students' achievement. , 2014, The American journal of psychology.

[22]  Joel H Rubenstein,et al.  Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma. , 2015, Gastroenterology.

[23]  Ryan Brydges,et al.  Patient Outcomes in Simulation-Based Medical Education: A Systematic Review , 2013, Journal of General Internal Medicine.

[24]  Vicki R LeBlanc,et al.  Personalized Oral Debriefing Versus Standardized Multimedia Instruction After Patient Crisis Simulation , 2009, Anesthesia and analgesia.