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      Einsatz von Virtual Reality in der HNO-Lehre: eine Alternative zum konventionellen Anatomiemodell Translated title: Use of virtual reality in ENT teaching: an alternative to the conventional anatomic model

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          Abstract

          Hintergrund

          Die Beurteilung des Mittelohrs erfordert ein komplexes dreidimensionales Verständnis, dessen Vermittlung für die curriculare Lehre ebenso wichtig ist wie für die ärztliche Weiterbildung.

          Zielsetzung

          Überprüft wurde, inwieweit Virtual Reality (VR) als Alternative zu konventionellen Lehrmethoden in der Vermittlung von Inhalten der Anatomie, Physiologie und Pathologie zum Einsatz kommen kann. Zielsetzung ist die Evaluation einer VR-gestützten Lehrmethode im Vergleich zur konventionellen Lehre am anatomischen Modell.

          Methodik

          Die Studie wurde als zweiarmige prospektive Single-Center-Studie im Sommersemester 2021 an der Universitätsklinik Freiburg durchgeführt. Für ein Modul zum Thema Mittelohr wurden 177 Studierende randomisiert in eine Kontroll- und Studiengruppe eingeteilt. Vorab wurden demografische Daten abgefragt sowie eine quantitative Evaluation hinsichtlich Kompetenz und persönlicher Haltung erhoben. Nach Bearbeitung der Modelle wurden die Gruppen formativ geprüft und die Ergebnisse vergleichend untersucht. Abschließend wurde durch ein Crossover der Modelle eine qualitative Evaluation der Modelle im Vergleich ermöglicht und eine erneute quantitative Evaluation durchgeführt.

          Ergebnisse

          In der formativen Prüfung konnte kein signifikanter Unterschied zwischen den Gruppen nachgewiesen werden. Die Evaluationen konnten eine gesteigerte Selbsteinschätzung der Wissenskompetenz, eine tendenziell ausgesprochen positive Haltung zur VR-Methode nach Kursabschluss sowie generell vorteilhafte subjektive Aspekte des VR-Modells aufweisen. Zudem zeigte sich ein positiver Effekt und ein positives Meinungsbild für die Vermittlung anatomischer Inhalte.

          Schlussfolgerung

          Der Einsatz von VR eignet sich als Alternative zu konventionellen Lehrmethoden in der curricularen HNO-Lehre. Die Ergebnisse zeigen bereits aktuell eine Gleichwertigkeit der VR und lassen ein großes Potenzial dieser Methode für zukünftige Lehraufgaben erwarten.

          Zusatzmaterial online

          Die Online-Version des Beitrages 10.1007/s00106-022-01252-z enthält eine weitere Abbildung: Fragebogen – Q2.

          Translated abstract

          Background

          Assessment of the middle ear requires a complex three-dimensional understanding, the teaching of which is just as important for curricular teaching as for further medical training.

          Objective

          The extent to which virtual reality (VR) can be used as an alternative to conventional educational methods for teaching anatomy, physiology, and pathology was examined. The objective was to evaluate a VR-supported teaching method in comparison to conventional learning on an anatomic model.

          Methods

          The study was conducted as a prospective two-arm single-center trial in the summer semester of 2021 at the University Hospital of Freiburg. During a seminar on the topic of the middle ear, 177 students were randomly assigned to either a control or a study group. Demographic data were collected in advance and a quantitative evaluation regarding competence and personal attitude was performed. After processing the models, the groups were formatively tested and the results were analyzed comparatively. Ultimately, crossover of the models enabled a qualitative comparative evaluation of the models and a renewed quantitative evaluation was carried out.

          Results

          No significant differences between the groups were identified in the formative testing. The evaluations demonstrated increased self-assessment of knowledge competence, a tendency towards a highly positive attitude towards the VR method after completion of the course, and generally beneficial subjective aspects of the VR model. In addition, there was a positive effect and a positive perception of the delivery of anatomic content.

          Conclusion

          Use of VR is suitable as an alternative to conventional teaching methods in curricular ENT teaching. The current evidence demonstrates the equality of VR and indicates its great potential for future educational tasks.

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          Most cited references26

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          Virtual Reality for Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

          Background Virtual reality (VR) is a technology that allows the user to explore and manipulate computer-generated real or artificial three-dimensional multimedia sensory environments in real time to gain practical knowledge that can be used in clinical practice. Objective The aim of this systematic review was to evaluate the effectiveness of VR for educating health professionals and improving their knowledge, cognitive skills, attitudes, and satisfaction. Methods We performed a systematic review of the effectiveness of VR in pre- and postregistration health professions education following the gold standard Cochrane methodology. We searched 7 databases from the year 1990 to August 2017. No language restrictions were applied. We included randomized controlled trials and cluster-randomized trials. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to rate the quality of the body of evidence. Results A total of 31 studies (2407 participants) were included. Meta-analysis of 8 studies found that VR slightly improves postintervention knowledge scores when compared with traditional learning (standardized mean difference [SMD]=0.44; 95% CI 0.18-0.69; I2=49%; 603 participants; moderate certainty evidence) or other types of digital education such as online or offline digital education (SMD=0.43; 95% CI 0.07-0.79; I2=78%; 608 participants [8 studies]; low certainty evidence). Another meta-analysis of 4 studies found that VR improves health professionals’ cognitive skills when compared with traditional learning (SMD=1.12; 95% CI 0.81-1.43; I2=0%; 235 participants; large effect size; moderate certainty evidence). Two studies compared the effect of VR with other forms of digital education on skills, favoring the VR group (SMD=0.5; 95% CI 0.32-0.69; I2=0%; 467 participants; moderate effect size; low certainty evidence). The findings for attitudes and satisfaction were mixed and inconclusive. None of the studies reported any patient-related outcomes, behavior change, as well as unintended or adverse effects of VR. Overall, the certainty of evidence according to the GRADE criteria ranged from low to moderate. We downgraded our certainty of evidence primarily because of the risk of bias and/or inconsistency. Conclusions We found evidence suggesting that VR improves postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education. The findings on other outcomes are limited. Future research should evaluate the effectiveness of immersive and interactive forms of VR and evaluate other outcomes such as attitude, satisfaction, cost-effectiveness, and clinical practice or behavior change.
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            Forced Disruption of Anatomy Education in Australia and New Zealand: An Acute Response to the Covid‐19 Pandemic

            Australian and New Zealand universities commenced a new academic year in February/March 2020 largely with “business as usual.” The subsequent Covid‐19 pandemic imposed unexpected disruptions to anatomical educational practice. Rapid change occurred due to government‐imposed physical distancing regulations from March 2020 that increasingly restricted anatomy laboratory teaching practices. Anatomy educators in both these countries were mobilized to adjust their teaching approaches. This study on anatomy education disruption at pandemic onset within Australia and New Zealand adopts a social constructivist lens. The research question was “What are the perceived disruptions and changes made to anatomy education in Australia and New Zealand during the initial period of the Covid‐19 pandemic, as reflected on by anatomy educators?.” Thematic analysis to elucidate “the what and why” of anatomy education was applied to these reflections. About 18 anatomy academics from ten institutions participated in this exercise. The analysis revealed loss of integrated “hands‐on” experiences, and impacts on workload, traditional roles, students, pedagogy, and anatomists' personal educational philosophies. The key opportunities recognized for anatomy education included: enabling synchronous teaching across remote sites, expanding offerings into the remote learning space, and embracing new pedagogies. In managing anatomy education's transition in response to the pandemic, six critical elements were identified: community care, clear communications, clarified expectations, constructive alignment, community of practice, ability to compromise, and adapt and continuity planning. There is no doubt that anatomy education has stepped into a yet unknown future in the island countries of Australia and New Zealand.
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              Immersive virtual reality as a teaching tool for neuroanatomy: Immersive VR as a neuroanatomy teaching tool

              Three-dimensional (3D) computer modeling and interactive virtual reality (VR) simulation are validated teaching techniques used throughout medical disciplines. Little objective data exists supporting its use in teaching clinical anatomy. Learner motivation is thought to limit the rate of utilization of such novel technologies. The purpose of this study is to evaluate the effectiveness, satisfaction, and motivation associated with immersive VR simulation in teaching medical students neuroanatomy.
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                Author and article information

                Contributors
                philip.schnakenburg@uniklinik-freiburg.de
                Journal
                HNO
                HNO
                Hno
                Springer Medizin (Heidelberg )
                0017-6192
                1433-0458
                7 December 2022
                7 December 2022
                : 1-8
                Affiliations
                [1 ]GRID grid.7708.8, ISNI 0000 0000 9428 7911, Klinik für Hals‑, Nasen- und Ohrenheilkunde, Medizinische Fakultät, , Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg, ; 79085 Freiburg, Deutschland
                [2 ]GRID grid.5963.9, Institut für Anatomie und Zellbiologie, Abteilung Molekulare Embryologie, , Albert-Ludwigs-Universität Freiburg, ; Freiburg, Deutschland
                [3 ]GRID grid.492141.b, Klinik für Diagnostische Radiologie, Kinderradiologie, Neuroradiologie und Interventionelle Radiologie, , St. Josefskrankenhaus, Artemed Kliniken Freiburg GmbH, ; Freiburg, Deutschland
                Article
                1252
                10.1007/s00106-022-01252-z
                9734900
                36477392
                f85b2d4c-6824-4520-a5c5-9254540a9594
                © The Author(s) 2022

                Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

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                History
                : 26 September 2022
                Funding
                Funded by: Universitätsklinikum Freiburg (8975)
                Categories
                Originalien

                digitalisierte lehre,medizinstudenten,akzeptanz,mittelohranatomie,digitale transformation,digitalised teaching,medical students,acceptance,middle ear anatomy,digital transformation

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