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Published on: June 23, 2023
Valor de la realidad virtual integrada con pedagogía multinivel basada en equipos en la formación de residencia
1Department of Anesthesia, Lishui Municipal Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China.
Background:
Achieving both technical and non-technical competencies in anesthesiology residency training remains challenging, highlighting the need for innovative educational strategies.
Methods:
In this single-center randomized controlled trial, 120 anesthesiology residents were assigned 1:1 to virtual reality (VR)-integrated team-based pedagogy (VR-TBP, n = 60) or conventional training (n = 60). The intervention combined immersive VR simulations with multilevel team-based teaching, while controls received standard lectures and bedside instruction. Primary outcomes included first-pass tracheal intubation success, intubation time, procedural errors, and ultrasound-guided nerve block performance. Secondary outcomes were Mini Clinical Evaluation Exercise (Mini-CEX), Anesthetists' Non-Technical Skills (ANTS), theoretical knowledge, self-efficacy, and satisfaction. Long-term endpoints at 6 and 12 months assessed skill retention, independent procedure completion, and adverse events.
Results:
Baseline characteristics were comparable. At 12 months, VR-TBP participants achieved higher first-pass intubation success (86.7% vs. 68.3%, p = 0.026), shorter intubation times (60.1 ± 11.0 vs. 66.8 ± 12.6 s, p = 0.006), fewer errors (1.4 ± 0.7 vs. 2.0 ± 0.9, p = 0.007), and greater nerve block success (81.7% vs. 65.0%, p = 0.041). Non-technical outcomes also favored VR-TBP, with higher Mini-CEX (6.7 ± 1.0 vs. 5.9 ± 1.1, p < 0.001) and ANTS scores (11.5 ± 1.6 vs. 9.9 ± 1.7, p < 0.001). Skill retention (88.4% vs. 76.5%, p < 0.001) and independent procedure completion (76.7% vs. 58.3%, p = 0.032) were superior, with comparable adverse event rates.
Conclusion:
Integrating VR-based simulation with team-based pedagogy significantly enhanced technical and non-technical competencies among anesthesiology residents, with sustained benefits at 12 months. VR-TBP offers an effective, reproducible model to strengthen residency training.
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