Case-Based Virtual Reality Simulation for Severe Pelvic Trauma Clinical Skill Training in Medical Students: Design and Pilot Study.

Background: Teaching severe pelvic trauma poses a significant challenge in orthopedic surgery education due to the necessity of both clinical reasoning and procedural operational skills for mastery. Traditional methods of instruction, including theoretical teaching and mannequin practice, face limitations due to the complexity, the unpredictability of treatment scenarios, the scarcity of typical cases, and the abstract nature of traditional teaching, all of which impede students' knowledge acquisition.

Objective: This study aims to introduce a novel experimental teaching methodology for severe pelvic trauma, integrating virtual reality (VR) technology as a potent adjunct to existing teaching practices. It evaluates the acceptability, perceived ease of use, and perceived usefulness among users and investigates its impact on knowledge, skills, and confidence in managing severe pelvic trauma before and after engaging with the software.

Methods: A self-designed questionnaire was distributed to 40 students, and qualitative interviews were conducted with 10 teachers to assess the applicability and acceptability. A 1-group pretest-posttest design was used to evaluate learning outcomes across various domains, including diagnosis and treatment, preliminary diagnosis, disease treatment sequencing, emergency management of hemorrhagic shock, and external fixation of pelvic fractures.

Results: A total of 40 students underwent training, with 95% (n=38) affirming that the software effectively simulated real-patient scenarios. All participants (n=40, 100%) reported that completing the simulation necessitated making the same decisions as doctors in real life and found the VR simulation interesting and useful. Teacher interviews revealed that 90% (9/10) recognized the VR simulation's ability to replicate complex clinical cases, resulting in enhanced training effectiveness. Notably, there was a significant improvement in the overall scores for managing hemorrhagic shock (t₃₉=37.6; 95% CI 43.6-48.6; P<.001) and performing external fixation of pelvic fractures (t₃₉=24.1; 95% CI 53.4-63.3; P<.001) from pre- to postsimulation.

Conclusions: The introduced case-based VR simulation of skill-training methodology positively influences medical students' clinical reasoning, operative skills, and self-confidence. It offers an efficient strategy for conserving resources while providing quality education for both educators and learners.