Educational value of mixed reality combined with a three-dimensional printed model of aortic disease for vascular surgery in the standardized residency training of surgical residents in China: a case control study

Background The simulated three-dimensional (3D) printed anatomical model of the aorta, which has become the norm in medical education, has poor authenticity, tactility, feasibility, and interactivity. Therefore, this study explored the educational value and effect of mixed reality (MR) combined with a 3D printed model of aortic disease in training surgical residents.Method Fifty-one resident physicians who rotated in vascular surgery were selected and divided into traditional (27) and experimental (24) teaching groups using the random number table method. After undergoing the experimental and traditional training routines on aortic disease, both the groups took a theoretical test on aortic disease and an assessment of the simulation based on the Michigan Standard Simulation Experience Scale (MiSSES) template. Their scores and assessment results were compared. The study was conducted at the Department of Vascular Surgery of Peking University People's Hospital, Beijing, China.Results In the theoretical test on aortic disease, the experimental teaching group obtained higher mean total scores (79.0 +/- 9.1 vs. 72.6 +/- 7.5, P = 0.013) and higher scores in anatomy/ pathophysiology (30.8 +/- 5.4 vs. 24.8 +/- 5.8; P < 0.001) than the traditional teaching group. The differences in their scores in the differential diagnosis (25.8 +/- 3.0 vs. 23.3 +/- 4.9; P = 0.078) and treatment (22.5 +/- 11.8 vs. 24.5 +/- 8.2; P = 0.603) sessions were insignificant. The MR-assisted teaching stratified the vascular residents through the MiSSES survey. Overall, 95.8% residents (23/24) strongly or somewhat agreed that the MR was adequately realistic and the curriculum helped improve the ability to understanding aortic diseases. Further, 91.7% residents (22/24) strongly or somewhat agreed that the MR-assisted teaching was a good training tool for knowledge on aortic diseases. All residents responded with "Good" or "Outstanding" on the overall rating of the MR experience.Conclusions MR combined with the 3D printed model helped residents understand and master aortic disease, particularly regarding anatomy and pathophysiology. Additionally, the realistic 3D printing and MR models improved the self-efficacy of residents in studying aortic diseases, thus greatly stimulating their enthusiasm and initiative to study.