JMIR Publications

ABSTRACT

Background:

Immunology education requires learners to integrate concepts across molecular, cellular, and clinical levels. However, conventional curricula often introduce these concepts sequentially, which may result in fragmented knowledge structures and difficulties in applying mechanistic understanding to translational contexts. Virtual simulations offer opportunities to create authentic learning environments, but evidence regarding how these environments facilitate knowledge integration and translational competency development remains limited.

Objective:

This study aimed to investigate whether and how a virtual CAR-T simulation supports knowledge reconstruction and translational learning in immunology education.

Methods:

A convergent mixed-methods study was conducted among undergraduate medical students participating in a virtual CAR-T simulation. The simulation integrated molecular visualization, experimental decision-making, and formative assessments within an authentic translational CAR-T learning environment. Learning outcomes were assessed using pre- and post-intervention knowledge assessments. Students also completed 5-point Likert-scale evaluations comparing the virtual simulation and traditional laboratory experiment. In addition, a separate 7-point Likert-scale questionnaire assessed students’ learning attitudes, knowledge preparation, authentic simulation experiences, and perceived competency development after the virtual simulation. Free-text comments were collected to further explore students’ learning experiences. Quantitative analyses included psychometric evaluation, confirmatory factor analysis, structural equation modelling, and mediation analysis, while qualitative data were analysed using reflexive thematic analysis.

Results:

Students demonstrated significant improvement in immunology knowledge after participating in the virtual CAR-T simulation and provided comparative evaluations of virtual simulation and traditional laboratory activities. Structural equation modelling identified a structured pattern of associations among learning attitudes, knowledge preparation, simulation experiences, and perceived competency development. Qualitative findings further indicated that students experienced the simulation as a process of connecting previously fragmented concepts, applying mechanistic reasoning, and reconstructing knowledge through authentic experimental contexts.

Conclusions:

A virtual CAR-T simulation may serve as an authentic translational learning environment that supports the integration and application of complex immunological concepts. These findings highlight the potential of technology-enhanced simulations to facilitate the transition from conceptual understanding to translational reasoning in biomedical education.