Interactive 360-degree Videos for Teaching Gut Endoscopy to Undergraduate Medical Students

Interactive 360-degree Videos for Teaching Gastrointestinal Endoscopy to Undergraduate Medical Students: a Randomized-controlled Cross-over Study

The study is a randomized-controlled cross-over study to evaluate the impact of integrating simulation-based teaching for gastrointestinal endoscopy for medical students. It will establish a novel pedagogy for teaching in a wide array of disciplines in healthcare settings. Building on an innovative virtual teaching platform, investigators will design interactive, immersive 360 virtual reality videos on Video-Vox with a facilitated structured debriefing platform in endoscopy teaching. In medical teaching, clinical exposure is indispensable to students' learning process. However, some premises are not easily accessible, such as operating theatres and endoscopy suites. By using 360 virtual reality technology, participants can be immersed in online screen-based learning in health situations that are difficult to visit in the real world.

The evident advantages of this technology will pave the way to novel approaches to medical education and training. Other real-life clinical settings, such as resuscitation scene in wards, surgical procedures in operation theatres, patient care in intensive care units, can adopt similar teaching platforms for the learner to get a 'first-hand' experience of the situation. The learning process is further reinforced by time-stamps and inquiry-based debriefing. This project will set a springboard for innovative pedagogy for undergraduate teaching in the medical curriculum.

Study Overview

• Status: Completed
• Conditions: Endoscopy, Gastrointestinal
• Intervention / Treatment: Other: Simulation-based training; Other: Didactic teaching

Detailed Description

The study would be conducted at the Li Ka Shing Faculty of Medicine, University of Hong Kong (HKU), Hong Kong, China. Second year students were recruited from the HKU's 6-year Bachelor of Medicine and Bachelor of Surgery (MBBS) program, with a cohort size ranging from 250-300 each year at the time this study. The first two years of this program comprise of predominately pre-clinical teaching and is followed by clinical teaching in subsequent years. GI endoscopy teaching for 2nd year students was revised in 2021 to include a lecture and on-site visit to an vacant endoscopy suite without demonstrating actual clinical procedures, to align with the Faculty's initiative for early clinical exposure.

Novice learners will be randomly divided into two groups in a 1:1 ratio. One group received simulation first, followed by conventional teaching (SIM-first); while the other received conventional teaching first, followed by simulation (CON-first). Three domains were assessed to evaluate the effectiveness of the interventions: perceived clinical competency, simulation effectiveness, and student satisfaction. These domains will be assessed after each teaching activity.

• Study Type: Interventional
• Enrollment (Actual): 68
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Hong Kong, China
    • The University of Hong Kong

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• MBBS Year 2 students in the administering institution
• voluntary participation

Exclusion Criteria:

• none

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: SIM-first; Students who receive simulation first, followed by conventional teaching	Other: Simulation-based training; A series of 360-degree videos were produced to simulate first-hand experience of the endoscopy room. The videos aimed to replicate authentic situations for clinical decision making. Segments of actual endoscopic procedures conducted in the endoscopic suite at Queen Mary Hospital, Hong Kong, were filmed with a 360-degree camera. Additional footages were filmed with surrogate patients and healthcare professionals to demonstrate the common communication errors and pitfalls that may occur while obtaining consent and conducting the time-out process. For the post-recording editing, views showing endoluminal appearances captured during the procedure were magnified. The vital signs monitor display was highlighted to indicate clinical deterioration. The viewer can pause the video at any time and can manipulate the viewing angle to examine all directions of the endoscopy room. Guiding questions and prompts were integrated within the videos, and were configured to appear at specific time points.
Placebo Comparator: CON-first; Students who receive conventional teaching first, followed by simulation	Other: Didactic teaching; Participants attended a 60-minute lecture that provided an overview of the different types of GI endoscopy and their indications, as well as common complications and the steps taken to minimize their occurrence.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-efficacy by Clinical Competence Questionnaire	Clinical Competency Questionnaire (CCQ) consists of 5 items of a 10-item 5-point Likert scale (5 = strongly agree, 4 = somewhat agree, 3 = neutral, 2 = somewhat disagree, 1 = strongly disagree). For each question, the minimum score is 0, the maximum score is 5.	Baseline, Day 2, Day 3

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Simulation effectiveness	The Simulation Effectiveness Tool - Modified (SET-M) is a 19-item instrument rated on a 3-point Likert scale (3 = strongly agree, 2 = somewhat agree, 1 = do not agree). For each item, the minimum score is 1, the maximum score is 3. The questionnaire comprises four subscales: pre-briefing, learning, confidence and debriefing.	Day 2 or Day 3
Student satisfaction	Participants will be invited to complete a short questionnaire assessing (i) their level of enjoyment and (ii) perceived improvement in knowledge acquisition and recall. These two items were rated using a 5-point Likert scale (5 = strongly agree, 4 = somewhat agree, 3 = neutral, 2 = somewhat disagree, 1 = strongly disagree). For each question, the minimum score is 1, the maximum score is 5. In addition, participants will be invited to give free-text response to identify their favorite aspect of the simulation training as well as areas of improvement.	Day 2, Day 3

Collaborators and Investigators

• Sponsor: The University of Hong Kong

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2024
• Primary Completion (Actual): December 30, 2025
• Study Completion (Actual): June 30, 2026

Study Registration Dates

• First Submitted: July 7, 2026
• First Submitted That Met QC Criteria: July 10, 2026
• First Posted (Actual): July 15, 2026

Study Record Updates

• Last Update Posted (Actual): July 15, 2026
• Last Update Submitted That Met QC Criteria: July 10, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: medical education; simulation; endoscopy
• Other Study ID Numbers: TDG1013

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data (IPD) collected in this study will be made available to other researchers upon reasonable request to the principal investigator.
• IPD Sharing Time Frame: The data will be made available upon reasonable request after publication of study data.
• IPD Sharing Access Criteria: The data will be made available upon reasonable request to the principal investigator.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No