Background Virtual reality (VR) produces a virtual manifestation of the real world and has been shown to be useful as a digital education modality. As VR encompasses different modalities, tools, and applications, there is a need to explore how VR has been used in medical education. Objective The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research. Methods We performed a search of 4 bibliographic databases in December 2020. Data were extracted using a standardized data extraction form. The study was conducted according to the Joanna Briggs Institute methodology for scoping reviews and reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results Of the 114 included studies, 69 (60.5%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15/114, 13.2%) and virtual worlds (20/114, 17.5%), which were mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68/114, 59.6%) and were of high interactivity (79/114, 69.3%). There is limited evidence on the use of more novel VR modalities, such as mobile VR and virtual dissection tables (8/114, 7%), as well as the use of VR for nonsurgical and nonpsychomotor skills training (20/114, 17.5%) or in a group setting (16/114, 14%). Only 2.6% (3/114) of the studies reported the use of conceptual frameworks or theories in the design of VR. Conclusions Despite the extensive research available on VR in medical education, there continue to be important gaps in the evidence. Future studies should explore the use of VR for the development of nonpsychomotor skills and in areas other than surgery and anatomy. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2020-046986

ObjectiveThe aim of this systematic review is to evaluate the various modalities available for extended ECG monitoring in the detection of atrial fibrillation (AF) following a cryptogenic stroke.MethodsMEDLINE (Ovid), EMBASE (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL) were searched from January 2011 to November 2021. All randomised controlled trials and prospective cohort studies including the use of extended ECG monitoring >24 hours with a minimum duration of AF of 30 s in patients with either cryptogenic strokes or transient ischaemic attacks were included. A random-effects model was used to pool effect estimates of AF detection rates from different ECG modalities.Results3924 studies were identified, of which 47 were included reporting on a pooled population of 6448 patients with cryptogenic stroke. The pooled AF rate for implantable loop recorders (ILRs) increased from 4.9% (3.0%–7.9%) at 1 month to 38.4% (20.4%–60.2%) at 36 months. Mobile cardiac outpatient telemetry (MCOT) had a significantly higher pooled AF detection rate of 12.8% (8.9%–17.9%) versus 4.9% (3.0%–7.9%) for ILR at 1 month (p<0.0001). Predictors for AF detection include duration of monitoring (p<0.0001) and age (p<0.0001) for ILRs, but only age for MCOTs (p<0.020).ConclusionMCOT has a higher rate of detection at 1 month and is less invasive. Beyond 1 month, compliance becomes a significant limitation for MCOT. MCOT may be a reasonable alternative AF screening tool for patients with cryptogenic stroke if ILR is not available.PROSPERO registration numberCRD42022297782.

BACKGROUND Virtual reality (VR) is a digital education modality that produces a virtual manifestation of the real world and it has been increasingly used in medical education. As VR encompasses different modalities, tools and applications, there is a need to explore how VR has been employed in medical education. OBJECTIVE The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research METHODS We performed a search of 4 bibliographic databases in December 2020, with data extracted using a standardized data extraction form. The data was narratively synthesized and reported in line with the PRISMA-ScR guidelines. RESULTS Of 114 included studies, 69 studies (61%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15 [14%]) and virtual worlds (20 [18%]), mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68 [60%]) and of high interactivity (79 [70%]). There is limited evidence on the use of more novel VR modalities such as mobile VR and virtual dissection tables (8 [7%]), as well as the use of VR for training of non-surgical and non-psychomotor skills (20 [18%]) or in group setting (16 [14%]). Only 3 studies reported the use conceptual frameworks or theories in the design of VR. CONCLUSIONS Despite extensive research available on VR in medical education, there continues to be important gaps in the evidence. Future studies should explore the use of VR for the development of non-psychomotor skills and in areas other than surgery and anatomy.

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