CLASSIE teaching – using virtual reality to incorporate medical ethics into clinical decision making

Abstract

Background Teaching medical ethics (ME) in the clinical environment is often difficult, uncalibrated and medical students get variable exposure to skilled educators. Explicit discussion of ethical dimensions of patient management is often neglected, as clinical teachers may feel inadequately skilled to do this. Methods We developed a suite of online modules. Each consisted of a clinical scenario filmed using virtual reality (VR) technology, linked to an adaptive, interactive, online tutorial which explicitly discussed the relevant ethical issues and guidelines. These were embedded in clinical placements of students to encourage the transfer of knowledge from these modules to clinical skill competency. We conducted a pilot study to evaluate these modules which examined student engagement, knowledge gains (self-perceived and measured) and user experience. We also reviewed reflections to assess the incorporation of these modules and transfer of knowledge into the clinical learning and skill development of the students. Results Engagement and self-perceived knowledge gains were extremely high. Students found these modules realistic, interesting and helpful. The measured knowledge gains (module exit quiz) were moderate. User experience was positive overall, although students were intolerant of any technical glitches. There was mixed feedback on whether the VR aspect of the clinical scenarios added value. Student reflections showed high level incorporation of these modules into clinical practice of the students and evidence of knowledge transfer (level 3 Kirkpatrick model of evaluation) in over ¾ of students. Conclusions This study showed that the use VR clinical scenarios combined with interactive online learning modules resulted in demonstrable high-level student engagement and learning gains in medical ethics and transfer of knowledge to clinical application. It standardised and ensured the student experience of high-quality educational deliverables in clinical years of medical education. This use of VR and online technology can be adapted for use in many areas of the medical curricula where we need to ensure the delivery of well calibrated, high quality, educational deliverables at scale for students.

Simulation-based assessments of fire emergency preparedness and response in virtual reality

“…Furthermore, the immersive encounter has exposed participants to the need of preparedness for decisive actions during a fire emergency. These results are also consistent with research that employs IVR towards FED and mitigation, e.g., Smith and Ericson [36], Tian et al [40], Torda [35], Patel and Dennick [46] and Lee Chang et al [9].…”

“…A method widely utilized for assessing the level of presence is the Slater-Usoh-Steed questionnaire (SUSQ). The SUSQ is also frequently employed for evaluating awareness during training and risk assessments in simulation environments [7,23,35]. Interestingly, SB EPR in combating fire indicates that participants exhibit similar levels of learning in simulations to those in actual scenarios [7,36].…”

Virtual Reality in Medical Students’ Education: Scoping Review

“…Of the 114 studies, 71 (62.2%) used a haptic surgical tool as their input interface [ 36 , 37 , 42 , 47 , 49 , 51 , 55 , 56 , 59 , 66 , 67 , 73 - 75 , 79 , 81 - 84 , 88 - 91 , 94 , 96 , 99 , 100 , 102 - 113 , 115 - 126 , 128 , 129 , 131 - 138 , 148 , 156 ] ( Figure 4 ). The next most common input device was a mouse (21/114, 18.4%) [ 8 , 38 - 41 , 43 - 45 , 50 , 54 , 58 , 61 , 62 , 64 , 68 , 71 , 76 - 78 , 80 , 92 , 101 , 139 - 142 , 144 , 151 , 157 - 164 ], followed by touch screen (8/114, 7%) [ 9 , 14 , 63 , 65 , 97 , 127 , 146 , 147 , 165 ,…”

“…Most of the studies included modalities that were of high interactivity (79/114, 69.3%) [ 35 - 37 , 42 , 43 , 45 - 51 , 55 - 57 , 59 , 66 , 67 , 70 , 73 - 75 , 79 , 81 - 84 , 86 - 91 , 93 , 94 , 96 , 98 - 100 , 102 , 103 , 105 - 113 , 115 , 116 , 118 - 129 , 131 - 135 , 137 , 143 , 145 - 147 , 156 , 168 , 171 , 173 , 174 ], whereas 16.7% (19/114) of the studies [ 9 , 38 - 41 , 62 - 64 , 68 , 69 , 76 - 78 , 97 , 104 , 140 , 141 , 151 , 153 , 159 , 161 , 162 , 165 , 169 ] included modalities that were of moderate interactivity and 14% (16/114) of the studies included modalities that were of low interactivity [ 8 , 14 …”

“…In terms of immersion, most of the studies included modalities that were semi-immersive (68/114, 59.6%) [ 36 , 37 , 42 - 44 , 47 , 49 , 51 , 53 , 55 , 56 , 59 , 61 , 66 , 67 , 69 , 73 , 75 , 81 , 83 , 84 , 86 , 88 , 89 , 91 , 93 , 94 , 96 , 99 - 101 , 103 , 106 , 108 , 109 , 111 - 117 , 120 , 121 , 123 - 129 , 131 - 139 , 142 , 146 , 156 , 166 , 168 - 170 , 176 ], followed by nonimmersive (26/114, 22.8%) [ 8 , 9 , 14 , 38 , 39 , 41 , 45 , 50 , 54 , 58 , 62 , 63 , 65 , 68 , 71 , 72 , 76 - 78 , 85 ,…”