Joshua Jacobs

Medical students learn over distance using virtual reality simulation.

Introduction: This article presents the results of a demonstration project that was designed with the goal to determine the feasibility and acceptability of medical students in using distance technology and virtual reality (VR) simulation within a problem-based learning (PBL). Methods: This pilot project involved students from the Universities of New Mexico and Hawaii and compared (1) control groups consisting of medical students in a tutor-guided PBL session using a text-based case, (2) distance groups using the same text-based case but interacting over distance from multiple sites, (3) groups using a VR simulation scenario integrated into the case without interaction over distance, and (4) combination groups interacting over distance from multiple sites with integration of a VR simulation scenario. Results: The study results suggest that it is possible to successfully conduct a PBL tutorial with medical students from two institutions with the integration VR and distributed distance interaction in combination or independently. The addition of these modalities did not interfere with learning dynamics when compared with traditional tutorial sessions. Conclusions: These findings suggest the feasibility and acceptability by students in the use of VR simulation integrated into a PBL learning session, as well as multipoint distance technologies that allowed interaction between students and tutors in different locations. The authors believe that these modalities can be applied where students and tutors from different institutions are in separate locations and can be used to support interactive experiential learning in a distributed network or on site and suggest areas for additional research.

Telemedicine in otolaryngology: implications, pitfalls, and roadblocks

The largest obstacle to telemedicine deployment is the lack of well controlled studies validating the safety and efficacy of this type of physician-patient encounter. These studies will eventually lead to clinical acceptance and the codes for reimbursement. The second largest obstacle for telemedicine is validating the change from live, three-dimensional viewing to a two-dimensional image on a monitor. In otolaryngology, video protocols need to be standardized for flexible nasopharyngolaryngoscopy and laryngostroboscopy. Because these are already commonly viewed on a two-dimensional monitor in the live setting, reimbursement could follow for these portions of the examination in a store-and-forward format. Viewing images of the tympanic membrane will be more challenging because the resolution of binocular microscopy will be difficult to duplicate. However, if telemedicine images can safely determine the difference between a normal and abnormal tympanic membrane, patients with an abnormal image can be triaged for a live visit.