Immersive virtual patient simulation compared with traditional education for clinical reasoning: a pilot randomised controlled study.

Immersive virtual patient simulation could help medical students in clinical reasoning, but there is a lack of literature on the effectiveness of this method in healthcare learning. A pilot randomised controlled study compared performance (exam score) on a clinical case in immersive virtual simulation to a text for physiotherapy students. In the experimental group, the clinical case was presented by an immersive 360° video that students watched with a standalone headset, whereas the control group used the text only. A survey investigated students' perceptions of the clinical case, their experience of virtual reality, and sense of presence. Twenty-three students in immersive virtual reality had a significantly lower total score than 25 students with a text. This difference appeared in the assessment part of a clinical case. More precisely, it concerned patient history (including a few other elements of assessment and bio-psycho-social factors, p = 0.007). Satisfaction and motivation were strong in the experimental group. In conclusion, the performance was higher in text than in virtual reality situations. Nevertheless, immersive virtual patient simulation remains an interesting tool could train novices to follow history-taking skills of a new patient, as similar to a real-life situation.

Effect of an FTO polymorphism on fat mass, obesity, and type 2 diabetes mellitus in the French MONICA Study.

We investigated the association between the rs9939609 (T>A) polymorphism in the FTO (fat mass- and obesity-associated) gene and obesity- and type 2 diabetes mellitus-related phenotypes in the French Multinational MONItoring of Trends and Determinants in CArdiovascular Disease (MONICA) Study (n = 3367). In the study, TA or AA subjects had higher body mass index (BMI) (P = .017), waist circumference (P = .017), and hip (P = .01) circumference in an A allele dose-dependent manner. The A allele was also significantly associated with higher plasma insulin levels (P = .05), higher insulin resistance index (homeostasis model assessment) (P = .02), and higher systolic blood pressure (P = .003); but these associations disappeared after adjustment for BMI. In the study, 598 subjects were obese (BMI >or=30 kg/m(2)); and 2769 subjects were not obese (BMI <30 kg/m(2)). Subjects bearing the A allele of rs9939609 had a higher risk of obesity (adjusted odds ratio [95% confidence interval] = 1.29 [1.06-1.58], P = .01) compared with TT subjects. Moreover, the homozygous AA genotype of rs9939609 was associated with a higher risk of type 2 diabetes mellitus (odds ratio = 1.45 [1.05-1.99], P = .02, 283 subjects with and 2601 subjects without type 2 diabetes mellitus), independently of BMI. In conclusion, the role of the A allele of the FTO rs9939609 polymorphism on the risk of obesity and type 2 diabetes mellitus was confirmed in the French MONICA Study.