Self-Directed Virtual Reality-Based Training versus Traditional Physician-Led Teaching for Point-of-Care Cardiac Ultrasound: A Randomized Controlled Study

Objective: To assess the learning efficacy of self-directed virtual reality ultrasound simulators as an alternative to traditional physician-led teaching for cardiac point-of-care ultrasound (POCUS) training. Setting: Tertiary university hospital in Singapore. Participants: Forty-three medical students with no prior formal ultrasound training. Interventions: Participants first completed an e-learning module on basic ultrasonography. Participants' baseline knowledge was subsequently assessed using a multiple-choice question (MCQ) test. Participants were then randomized to either physician-led (PL) teaching or independent learning with a virtual-reality (VR) simulator to learn the 4 cardiac POCUS views. A post-training MCQ test and a practical skills test scored by 2 blinded assessors were conducted. Students repeated the MCQ test and skills test 1 month later. Measurements and Main Results: The VR group had higher baseline MCQ scores compared to the PL group (mean, 13.4 v 10.7). Immediately post-training, the PL group had a greater improvement in mean MCQ scores (from baseline) and higher total practical scores compared to the VR group (p = 0.03 and p < 0.01, respectively). At 1 month post-training, the PL group similarly had a greater mean change from baseline MCQ scores, but this difference was not statistically significant (p = 0.12). For practical scores, the VR group scored higher than the PL group, Conclusions: Our study demonstrates that at 1 month post-training, self-directed VR training was noninferior to PL training. Although differences observed were not significant, there were trends to suggest enhanced retention of knowledge and skills with VR learning. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.