虚拟现实与医疗教学外文翻译中英文Word文档格式.docx

虚拟现实与医疗教学外文翻译中英文Word文档格式.docx

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MedicalStudentPerspectivesontheUseofImmersiveVirtualRealityforClinicalAssessmentTraining

MatthewZackoff,FrancisReal，

BradleyCruse，DavidDavis，MelissaKlein

What'

sNew?

Medicalstudentsreportedanimmersivevirtualreality（VR）curriculumonrespiratorydistressasclinicallyaccurateandlikelytoimpactfuturepatientassessment.VRtrainingwasratedasequallyormoreeffectivethanhigh-fidelitymannequinsandstandardizedpatientsbutlesseffectivethanbedsideteaching.

Keywords：

Clinicalassessment，respiratorydistress，virtualreality

Background

Thepracticeofmedicinehastraditionallyreliedonanapprenticeshipmodelforclinicaltraining–anapproachinwhichbedsideteachingwastheprimarysourceforknowledgetransfer.However,thefrequencyofbedsideteachingisdecliningduetodutyhourrestrictions,increasedpatientturnover,andcompetingdemandsforphysicians'

time.

Alternativestobedsideteachinghaveemergedincludingsimulation-basedmedicaleducationthoughcurrentapproachesarelimitedinapplicabilitytoandfunctionalityforpediatrictraining.Forinstance,standardizedpatientsarenotavailableformanypediatricconditionsespeciallyfordiseasesthatpredominantlyaffectinfants.Moreover,patientsimulatorsoftencannotdisplaycriticalphysicalexamfindingsfordiscriminatingbetweensickandhealthypatients（egmentalstatus,workofbreathing,perfusionchanges）.

Anemergingeducationalmodality,immersivevirtualreality（VR）,couldpotentiallyfillthisgap.ImmersiveVRutilizesathree-dimensional,computergeneratedenvironmentinwhichusersinteractwithgraphicalcharacters（avatars）.Whilescreen-basedsimulationtraininghasbeendemonstratedtoenhancelearningoutcomes,immersiveVRhasthepotentialtohaveabroaderimpactthroughincreasedlearnerengagement,andimprovedspatialrepresentationandlearningcontextualization.Todate,thistechnologyhasdemonstratedeffectivenessincommunicationskillstraining;

however,ithasnotbeeninvestigatedforclinicalassessmenttraining.ToevaluatetheroleofimmersiveVRinmedicalstudentclinicalassessmenttraining,wecreatedaVRcurriculumfocusedonrespiratorydistressininfants.OurpilotstudyexploredmedicalstudentattitudestowardVRandperceptionsofVRcomparedtoothercommonmedicaleducationalmethods.

EducationalApproachandInnovation

Settingand 

Study 

Population

AnIRBapprovedprospectivepilotstudywasconductedatCincinnatiChildren'

sHospitalMedicalCenter,alargeacademicchildren'

shospital,duringthe2017to2018academicyear.Arandomizedsampleofthird-yearmedicalstudents,baseduponpredeterminedclinicalteamassignmentduringtheirpediatricrotation,wasinvitedtoparticipateinaVRcurriculum.

Curriculum 

Design

Thecurriculargoal,toimprovethirdyearmedicalstudents'

abilitytoappropriatelycategorizeapediatricpatient'

srespiratorystatus,alignswithanAssociationofAmericanMedicalCollegesCoreEntrustableProfessionalActivityforenteringresidency,theabilitytorecognizeapatientthatrequiresanurgentoremergentescalationofcare.

Toaddressthisgoal,animmersiveVRcurriculumusingtheclinicalscenarioofanadmittedinfantwithbronchiolitiswasdevelopedcollaborativelybetweenclinicians,educators,andsimulationdevelopers.AvirtualCincinnatiChildren'

sHospitalMedicalCenterinpatienthospitalroomwascreatedusingtheUnitydevelopmentplatformandwasexperiencedthroughanOculusRiftheadset.Theenvironmentincludedavitalsignsmonitor,virtualstethoscope,andavatarsforthepatientandpreceptor.Thepatientavatarcoulddemonstratekeyexamfindings（iementalstatus,workofbreathing,andbreathsounds）thatcorrelatedwiththreeclinicalscenarios:

1）nodistress,2）respiratorydistress,and3）impendingrespiratoryfailure.Thedisplayedvitalsignsandauscultatoryfindingsmatchedtheclinicalstatusofthepatient.Learnersreceivedfeedbackontheirperformanceimmediatelyfollowingeachsimulatedcase.Thepreceptoravatar,controlledbyaphysicianfacilitator（M.Z.,F.R.）,guidedthestudentthroughtheVRsimulation.Learnerswereexpectedtorecognizeandinterpretthevitalsigns,physicalexam,andauscultatoryfindingsandcometoanoverallassessmentofthepatient'

srespiratorystatus.Detailedalgorithmscorrelatinglearnerinputtoavatarresponsesallowedforstandardizationoftheavatarpreceptorprompts.Forexample,ifastudentdidnotcommentonthepatient'

slungsounds,thefacilitatorisguidedtoselecttheavatarprompt,“Whatdoyouthinkofhislungsounds?

”Facilitator-providedfeedbackforeachscenariowasstandardizedtoensureconsistentlearnerexperiences.

Scenarioswerepilotedonfourcriticalcareattendingphysicians,twohospitalists,twogeneralpediatricians,fourcriticalca