Use of 360° Video for a Virtual Operating Theatre Orientation for Medical Students.

BACKGROUND: Operating theatres are a unique learning environment that some learners find daunting. By employing orientations some of these fears can be reduced but these require operating theatre space and personnel and are not standardized. METHODS: We utilized a 360° camera to generate a "virtual" 360° video orientation. It was filmed in first-person perspective to improve engagement and to make it more experiential. EVALUATION: It was shown to 34 medical students in a tutorial setting before their first operating theatre experience. We analyzed their knowledge gain with use of a questionnaire and change in self-reported confidence using a 7-point Likert scale. The students' knowledge improved from 38.4% to 78.2% (p < 0.01) as well as self-reported confidence from 4.3 to 6.1 (p < 0.01). DISCUSSION: The use of 360° video for a virtual operating theatre orientation improved knowledge and confidence of learners which suggests its expanded use in medical education.

Virtual Patient Journey: a novel learning resource.

BACKGROUND: Virtual Patient Journey (VPJ) is a novel online resource that follows a patient through their illness and integrates first-person video content with in-video decision making, allowing the student to take on the responsibility of a health care professional. The aim of our project was to compare this new VPJ format with standard teaching tutorials. METHODS: Third-year medical students selected from two Bristol hospitals were allocated to either the VPJ format or a typical tutorial-style teaching session. Both formats covered an identical level and scope of material and lasted the same length of time. Data were collected on pre- and post-test knowledge and confidence gain using self-reported questionnaires at the time of the teaching. RESULTS: The study recruited 30 students. The average knowledge gain for the VPJ group and for the tutorial group was 39% and 35%, respectively. The confidence increase was 2.4 and 1.8 on a scale of 1-10 for the VPJ and tutorial groups, respectively. Of the students who used the VPJ, 92% believed that it was a useful teaching resource and 96% enjoyed the VPJ experience and would re-watch the material at home. CONCLUSIONS: VPJ can expose students to clinical situations that they may not see on placement and can help to deliver a baseline level of clinical exposure and knowledge. Our VPJ may help overcome the rigidity of current virtual patients in teaching a range of core competencies and also allowing the students to take responsibility for a patient's care in a safe, controlled environment.

First-person perspective video to enhance simulation.

BACKGROUND: Simulation training is increasingly being used as part of the undergraduate medical curriculum, but it remains time and faculty member intensive. To improve efficacy, videos have been used prior to the simulation of practical procedures; however, using videos prior to simulation training concerning the management of patients who are unwell has not been investigated. The aim of this project was to see whether clinical decision-making and non-technical skills can be improved if a video is used prior to simulation training, and uniquely to enhance the authenticity we filmed it using a first-person perspective. METHODOLOGY: We conducted a randomised controlled trial with 40 final-year medical students randomised into two groups. One group viewed a video filmed in first person prior to a simulation scenario, whereas the other group did not view the video. The two groups then carried out the simulation and were assessed with 'time to' investigation and treatment decisions. Further quantitative data were collected for non-technical skills using the Ottawa Crisis Resource Management (OCRM) score. Qualitative data were collected from the students as to the perceived ease of use and helpfulness of the video. Simulation training is increasingly being used as part of the undergraduate medical curriculum RESULTS: The students who watched the video appeared to perform better in clinical decision-making and non-technical skills. The students were extremely receptive to the use of a first-person perspective video, and highlighted its perceived realism and its help as a memory aid. DISCUSSION: The use of this style of video was warmly received by students and opens the possibility of further use to enhance simulation training.

Acting like a doctor: oral case presentation curriculum for medical students.

This article was migrated. The article was marked as recommended. Background Verbal communication is an important element to clinical practice and an integral part of undergraduate medical education. The oral case presentation (OCP) is often used in professional verbal communication and remains commonplace in the clinical setting. The OCP additionally has a complex role in undergraduate teaching. Methods We designed a OCP curriculum taking into account reasoning, rhetorical and linguistic mechanisms. Delivered through a content and drama workshop involving a trained theatre actor to 45 pre-clinical, undergraduate medical students at our U.K. institution. Students were assessed objectively at weekly intervals by trained faculty. A paired t-test was performed to determine if the curriculum was effective in increasing OCP scores. Students' confidence was assessed using Likert scales. Findings An overall mean score improvement (M=20.3, SD 14.6, N=45) was significantly greater than zero, t (44) =9.3, two tail p <0.05, providing evidence that the curriculum was effective. A 95% confidence interval around the mean difference in score was 15.9-24.7. Confidence scores for both non-verbal and verbal elements of the OCP improved. Conclusion This curriculum led to an improvement in OCP scores and increased our students 'confidence with this modality of communication. Consideration should be given to incorporating dedicated teaching of the OCP in undergraduate education.

Predicting blood transfusion in patients undergoing minimally invasive oesophagectomy.

AIM: To evaluate predictors of allogenic blood transfusion requirements in patients undergoing minimal invasive oesophagectomy at a tertiary high volume centre for oesophago-gastric surgery. METHODS: Retrospective analysis of all patients undergoing minimal access oesophagectomy in our department between January 2010 and December 2011. Patients were divided into two groups depending on whether they required a blood transfusion at any time during their index admission. Factors that have been shown to influence perioperative blood transfusion requirements in major surgery were included in the analysis. Binary logistic regression analysis was performed to determine the impact of patient and perioperative characteristics on transfusion requirements during the index admission. RESULTS: A total of 80 patients underwent minimal access oesophagectomy, of which 61 patients had a laparoscopic assisted oesophagectomy and 19 patients had a minimal invasive oesophagectomy. Perioperative blood transfusion was required in 28 patients at any time during hospital admission. On binary logistic regression analysis, a lower preoperative haemoglobin concentration (p < 0.01), suffering a significant complication (p < 0.005) and laparoscopic assisted oesophagectomy (p < 0.05) were independent predictors of blood transfusion requirements. DISCUSSION: It has been reported that requirement for blood transfusion can affect long-term outcomes in oesophageal cancer resection. Two factors which could be addressed preoperatively; haemoglobin concentration and type of oesophageal resection, may be valuable in predicting blood transfusions in patients undergoing minimally invasive oesophagectomy. CONCLUSION: Our analysis revealed that preoperative haemoglobin concentration, occurrence of significant complications and type of minimal access oesophagectomy predicted blood transfusion requirements in the patient population examined.

Live lecture versus video podcast in undergraduate medical education: A randomised controlled trial.

BACKGROUND: Information technology is finding an increasing role in the training of medical students. We compared information recall and student experience and preference after live lectures and video podcasts in undergraduate medical education. METHODS: We performed a crossover randomised controlled trial. 100 students were randomised to live lecture or video podcast for one clinical topic. Live lectures were given by the same instructor as the narrator of the video podcasts. The video podcasts comprised Powerpoint™ slides narrated using the same script as the lecture. They were then switched to the other group for a second clinical topic. Knowledge was assessed using multiple choice questions and qualitative information was collected using a questionnaire. RESULTS: No significant difference was found on multiple choice questioning immediately after the session. The subjects enjoyed the convenience of the video podcast and the ability to stop, review and repeat it, but found it less engaging as a teaching method. They expressed a clear preference for the live lecture format. CONCLUSIONS: We suggest that video podcasts are not ready to replace traditional teaching methods, but may have an important role in reinforcing learning and aiding revision.