<p>Virtual Reality and Physical Models in Undergraduate Orthopaedic Education: A Modified Randomised Crossover Trial</p>

Abstract

Background: Orthopaedic surgery is underrepresented in the United Kingdom medical school curriculum, with an average of less than 3 weeks of exposure over the five-year degree. This study evaluates the effectiveness of high-fidelity virtual reality (VR) and physical model simulation in teaching undergraduate orthopaedic concepts. Methods: A modified randomised crossover trial was used. Forty-nine students were randomly allocated to two groups, with thirty-three finishing the six-week follow-up assessment. All undergraduate medical students were eligible for inclusion. Both groups were given introductory lectures, before completing a pre-test with questions on the principles of fracture fixation and osteotomy. Each group then received a lecture on these topics with the same content, but one was delivered with VR and the other with physical models. Both groups completed the post-course assessments. Knowledge was assessed by way of questionnaire immediately before, immediately after, and six-weeks after. Results: In the VR group, participants improved their post-training score by 192.1% (U=32; p<0.00001). In the physical models group, participants improved their post-training scores by 163.1% (U=8.5; p<0.00001). Overall, there was no statistically significant difference in the total means of post-training test scores between the VR and the physical models study groups (U=260.5; p=0.4354). Conclusion: Both VR and physical models represent valuable educational adjuncts for the undergraduate medical curriculum. Both have demonstrated improvements in immediate and long-term knowledge retention of key orthopaedic concepts.

Musculoskeletal education in undergraduate medical curricula–A systematic review

“…In all 3 studies, podcasts scored positively in terms of student satisfaction and perception 40–42 . The study evaluating knowledge gained using virtual reality vs physical model simulation showed no overall statistically significant difference between the 2 43 …”

“…Three studies evaluated podcast learning compared to either textbook or lecture series 40–42 . One study evaluated a blended learning (BL) approach 39 and one assessed high‐fidelity virtual reality 43 . There was no difference in terms of knowledge or skill using a BL approach vs problem‐based learning (PBL) alone; however, 74.3% rated BL helpful in preparing for clinical practice, and it was positively accepted by 97% 39 .…”

Virtual Simulation in Undergraduate Medical Education: A Scoping Review of Recent Practice

“…Of the included 92 papers, 38% (35 paper) reported the integration of VS in surgical training for medical undergraduates, among which 12 studies focused on the instructional application of virtual endoscopic [including laparoscopic ( 31 , 36 , 37 , 56 , 73 , 76 , 78 , 98 ), arthroscopic ( 26 , 47 , 48 ), and otoscopic ( 53 )] simulators; 7 studies were for learning procedures or concepts of orthopedic and bone surgery ( 32 , 33 , 35 , 45 , 57 , 66 , 70 ); 5 studies were based on VS system or platform as a primary mode of teaching neurosurgical procedures, neuroanatomy and pathologies ( 22 , 28 , 71 , 80 , 81 ); 4 papers ( 38 , 61 , 75 , 84 ) reported the exposure of medical undergraduates as novice surgeons to the robotic surgery simulators; 2 studies conducted by the same team ( 64 , 65 ) explored the VR simulation-based training in Cochlear Implant surgery; the other 2 were for learning basic motor skills in liver surgery ( 50 , 52 ); 1 in minimally invasive surgery ( 97 ), and 1 in vitreoretinal surgery ( 67 ). In addition, Fukuta et al ( 46 ) generated a virtual operating theater orientation to improve knowledge and confidence of medical undergraduates.…”

Critical Success Factors for Virtual Reality Applications in Orthopaedic Surgical Training: A Systematic Literature Review

“…There are two forms of efficacy measured related to VR in orthopaedics. In the first type, VR is used as an alternate teaching device in orthopaedic surgery, with higher efficacy indicated by improved surgical skills and reduction of surgical complications [21][22][23]. The second form occurs as VR is used as an appraisal instrument to predict and quantify the abilities of residents [24][25][26].…”

“…VR-based training is utilized in two different ways in orthopaedic surgery. First, to improve comprehension and technical performance of the trainee in comparison to traditional methods [21][22][23], and second, to appraise surgical skills of trained orthopaedic surgeons [24][25][26]. Understanding the critical success factors (CSFs) behind these reports could highlight a research opportunity to further improve the system, particularly at the integration stage of each individual system, into the curriculum of surgeon training.…”