虚拟现实与医疗教学外文翻译中英文.docx
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虚拟现实与医疗教学外文翻译中英文.docx
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虚拟现实与医疗教学外文翻译中英文
沉浸式虚拟现实与医疗教学中英文2019
英文
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
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- 虚拟现实 医疗 教学 外文 翻译 中英文
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