Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 11, 2024
Date Accepted: Mar 19, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Knowledge Gain and the Impact of Stress in a Virtual Reality-based Medical Emergencies Training with Automated Feedback – A Randomized Controlled Trial.
ABSTRACT
Background:
A significant gap exists in the knowledge and procedural skills of medical graduates when it comes to managing emergencies. In response, highly immersive virtual-reality (VR)-based learning environments have been developed to train clinical competencies.
Objective:
This study aimed to assess the effectiveness of virtual-reality-based (VR-based) simulation training, augmented with automated feedback, compared to video seminars at improving emergency medical competency among medical students. Furthermore, the study investigated the relationship between learning outcomes and physiological stress markers.
Methods:
72 senior medical students underwent VR-based emergency training (intervention) or viewed video seminars (control) on two topics (acute myocardial infarction and exacerbated chronic obstructive pulmonary disease) in an intra-individual crossover design. Levels of applied knowledge were assessed objectively by open-response tests pre/post-intervention and after 30 days. Additionally, two electrodermal activity markers representing physiological stress response were measured during VR sessions using a wearable sensor. Participants also rated their estimated learning success and perceived stress.
Results:
Immediately after the intervention, short-term knowledge gain was comparable between both groups. However, VR training led to significantly better long-term knowledge gain compared to video seminars (VR: 17.8 ± 15.1%, control: 11.9 ± 18.0%, difference: -5.9, 95% CI [-11.5, -0.4]). Participants rated the VR training as significantly more effective for learning. While physiological stress markers generally increased during VR sessions, they correlated only weakly and negatively with knowledge gains. No correlation was found between perceived stress and knowledge outcomes.
Conclusions:
VR-based simulation training with automated feedback can provide substantial long-term learning advantages over a traditional method in the context of emergency-medicine education. Although VR training induced stress, it had only a weak impact on performance and self-assessment. Given the time constraints faced by clinical educators, self-moderated VR-based learning proves to be a valuable addition to medical training.
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Copyright
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