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Psoriasis Area and Severity Index Training via Virtual Reality Application: New Way of Effective Teaching
Sascha Gerd Decker1, Falk Ochsendorf1, Michael Gairing2
1Department of Dermatology, Goethe University Frankfurt, University Hospital, Frankfurt, Germany.
Introduction:
Systemic treatment decisions for psoriasis are often initiated and guided depending on the severity of the disease, determined by the validated Psoriasis Area and Severity Index (PASI). Therefore, accurate evaluation of disease severity is crucial. However, exact and reproducible PASI assessment requires training. A virtual reality (VR)-PASI program could improve empowerment of healthcare providers and grading accuracy. The aim of this study was to compare the effectiveness of a VR-PASI training program to standard PASI teaching.
Methods:
In a randomised prospective trial, a classical lecture and a VR program were compared in 70 medical students (study participants) without previous knowledge and training in skin assessment. Effectiveness of training was measured by determining a PASI score in real patients and comparing the results to those of a trained assessor. Furthermore, the rating of quality and satisfaction of both training methods was measured in both educational groups.
Results:
Both groups were equally interested in dermatology, all study participants had little to no experience with PASI, and both groups had similarly little to no experience in dealing with VR. VR-trained PASI raters achieved better results assessing correct PASI severity compared to those trained via classical lecture (U = 397.5, p = 0.011). The effect size, calculated using Rosenthal's method, was R = 0.302 (moderate effect). Median difference of PASI score was 1.5 (95% confidence interval [CI]: 0.3-2.4). Median difference scores of classical lecture group (PASI Δ: 2.7) was less accurate than in VR group (PASI Δ: 1.1), indicating a potentially clinically relevant effect for median difference (1.5 (95% CI: 0.3-2.4). VR group showed higher accuracy in the application of the PASI and reported both higher satisfaction with the learning unit and a better experience in implementing the teaching method.
Conclusion:
In untrained raters, PASI training via the VR program led to higher accuracy in severity assessment compared to a classical lecture.
