JMIR Publications

ABSTRACT

Background:

The integration of new technologies such as virtual worlds, clinical environments simulation, and case-based learning can contribute to improving the practical understanding of medical students, developing technical and communication skills, and promoting educational innovation.

Objective:

This study aimed to design and develop a gamified learning experience on emergency radiology in the virtual world Second Life (SL), and to analyze the reproducibility of the experience, as well as the outcomes and students' perceptions.

Methods:

The experience was integrated into a two-week radiology clerkship. Teams of 3-4 students reviewed seven clinical cases presented in virtual Objective Structured Clinical Examination (OSCE) stations and answered two randomly assigned cases. The students then discussed the cases in a synchronous virtual meeting and received a seminar on emergency radiology. Finally, they voluntarily completed a perception questionnaire, which included questions on a 1 to 5 Likert scale (from strongly disagree to strongly agree), assessment of the cognitive load of the game, 10-point rating of the experience, and open-ended comments.

Results:

A total of 352 students participated in this study over two academic years: 182 in 2020-21 and 170 in 2021-22. The students demonstrated strong competence in team-based resolution of clinical cases, with mean scores (± standard deviation) of 7.36 ± 1.35 in 2020-21 and 8.41 ± 0.99 in 2021-22 (P < .001). The highest cognitive load was observed in avatar editing and OSCE case-solving, with median values of 7 (95% CI = 0.20) and 6 (95% CI = 0.19), respectively, and significantly lower values recorded in 2021-22 (P = .047 and P < .001, respectively). The perception questionnaire had a 90.6% response rate. The students rated the experience highly, with average scores exceeding 8.0 out of 10 across various aspects. Notably, the highest-rated aspects were the teaching staff (9.13±1.15), OSCE cases (8.60±1.31), project organization (8.42±1.67), OSCE rooms (8.36±1.62). The lowest rated aspect was the connectivity to Internet (6.68±2.53). Despite the positive scores, all aspects were rated significantly lower in 2021-22 compared to 2020-21 (P-values ranging from < .001 to .028).

Conclusions:

This study shows that a game-based learning experience in the SL virtual world, featuring virtual OSCE stations and team-based activities, is feasible and reproducible within a radiology clerkship. By combining asynchronous activities with synchronous group meetings in a playful context, this experience fosters clinical reasoning and teamwork, providing educational value that students highly appreciate. Expanding the use of OSCE stations in 3D virtual environments could further benefit education in radiology and other medical fields.