Endoscopy, Gastrointestinal
Conditions
Keywords
endoscopy, simulation, medical education
Brief summary
The study is a randomized-controlled cross-over study to evaluate the impact of integrating simulation-based teaching for gastrointestinal endoscopy for medical students. It will establish a novel pedagogy for teaching in a wide array of disciplines in healthcare settings. Building on an innovative virtual teaching platform, investigators will design interactive, immersive 360 virtual reality videos on Video-Vox with a facilitated structured debriefing platform in endoscopy teaching. In medical teaching, clinical exposure is indispensable to students' learning process. However, some premises are not easily accessible, such as operating theatres and endoscopy suites. By using 360 virtual reality technology, participants can be immersed in online screen-based learning in health situations that are difficult to visit in the real world. The evident advantages of this technology will pave the way to novel approaches to medical education and training. Other real-life clinical settings, such as resuscitation scene in wards, surgical procedures in operation theatres, patient care in intensive care units, can adopt similar teaching platforms for the learner to get a 'first-hand' experience of the situation. The learning process is further reinforced by time-stamps and inquiry-based debriefing. This project will set a springboard for innovative pedagogy for undergraduate teaching in the medical curriculum.
Detailed description
The study would be conducted at the Li Ka Shing Faculty of Medicine, University of Hong Kong (HKU), Hong Kong, China. Second year students were recruited from the HKU's 6-year Bachelor of Medicine and Bachelor of Surgery (MBBS) program, with a cohort size ranging from 250-300 each year at the time this study. The first two years of this program comprise of predominately pre-clinical teaching and is followed by clinical teaching in subsequent years. GI endoscopy teaching for 2nd year students was revised in 2021 to include a lecture and on-site visit to an vacant endoscopy suite without demonstrating actual clinical procedures, to align with the Faculty's initiative for early clinical exposure. Novice learners will be randomly divided into two groups in a 1:1 ratio. One group received simulation first, followed by conventional teaching (SIM-first); while the other received conventional teaching first, followed by simulation (CON-first). Three domains were assessed to evaluate the effectiveness of the interventions: perceived clinical competency, simulation effectiveness, and student satisfaction. These domains will be assessed after each teaching activity.
Interventions
A series of 360-degree videos were produced to simulate first-hand experience of the endoscopy room. The videos aimed to replicate authentic situations for clinical decision making. Segments of actual endoscopic procedures conducted in the endoscopic suite at Queen Mary Hospital, Hong Kong, were filmed with a 360-degree camera. Additional footages were filmed with surrogate patients and healthcare professionals to demonstrate the common communication errors and pitfalls that may occur while obtaining consent and conducting the time-out process. For the post-recording editing, views showing endoluminal appearances captured during the procedure were magnified. The vital signs monitor display was highlighted to indicate clinical deterioration. The viewer can pause the video at any time and can manipulate the viewing angle to examine all directions of the endoscopy room. Guiding questions and prompts were integrated within the videos, and were configured to appear at specific time points.
OTHERDidactic teaching
Participants attended a 60-minute lecture that provided an overview of the different types of GI endoscopy and their indications, as well as common complications and the steps taken to minimize their occurrence.
Sponsors
The University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* MBBS Year 2 students in the administering institution * voluntary participation
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-efficacy by Clinical Competence Questionnaire | Baseline, Day 2, Day 3 | Clinical Competency Questionnaire (CCQ) consists of 5 items of a 10-item 5-point Likert scale (5 = strongly agree, 4 = somewhat agree, 3 = neutral, 2 = somewhat disagree, 1 = strongly disagree). For each question, the minimum score is 0, the maximum score is 5. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Simulation effectiveness | Day 2 or Day 3 | The Simulation Effectiveness Tool - Modified (SET-M) is a 19-item instrument rated on a 3-point Likert scale (3 = strongly agree, 2 = somewhat agree, 1 = do not agree). For each item, the minimum score is 1, the maximum score is 3. The questionnaire comprises four subscales: pre-briefing, learning, confidence and debriefing. |
| Student satisfaction | Day 2, Day 3 | Participants will be invited to complete a short questionnaire assessing (i) their level of enjoyment and (ii) perceived improvement in knowledge acquisition and recall. These two items were rated using a 5-point Likert scale (5 = strongly agree, 4 = somewhat agree, 3 = neutral, 2 = somewhat disagree, 1 = strongly disagree). For each question, the minimum score is 1, the maximum score is 5. In addition, participants will be invited to give free-text response to identify their favorite aspect of the simulation training as well as areas of improvement. |
Countries
China
Outcome results
None listed