Using 360-degree video for teaching emergency medicine during and beyond the COVID-19 pandemic

Figures & data

Figure 1. Study flow diagram. The three arms show the framework of data collection: (a) students' attitudes towards the video 360 technology, its appropriateness in EM, and its general effectiveness, by online anonymous questionnaires; (b1) students' assessment by multiple-choice questionnaires; (b2) students' assessment by interview-based oral examination. Abbreviations: CPR: Cardio-Pulmonary Resuscitation; ECG: electrocardiogram; ICT: Information and Communication Technology.

Table 1. Students' perceptions about the contribution of the video 360 scenarios to their learning, and students' attitudes towards using video 360 for education in emergency medicine and general medical education (anonymous answers).

Variable	Total	Female	Male	p-value ^a
	n = 78	n = 53	n = 25
Actually prepared	Questionnaire items Q3–Q10
8 items, Cronbach' alpha	0.898	0.846	0.951	NA
Prepared Total40	Sum of items Q3–Q10
Mean ± std.dev.	32.13 ± 5.63	31.49 ± 4.66	33.48 ± 7.2	.073
(min–max)	(12–40)	(20–40)	(12–40)
Median (IQR)	32 (28–36)	32 (28–35)	35 (28–40)
Perceived contribution of the 360 scenarios	Questionnaire items Q11–Q16
6 items, Cronbach' alpha	0.919	0.923	0.911	NA
360 scenario Total30	Sum of items Q11–Q16
Mean ± std.dev.	27.35 ± 3.54	27.25 ± 3.61	27.56 ± 3.48	.442
(min–max)	(15–30)	(15–30)	(20–30)
Median (IQR)	29 (25–30)	29 (25–30)	30 (24–30)
Knowledge	Questionnaire item Q17
Mean ± std.dev.	4.46 ± 0.73	4.36 ± 0.71	4.68 ± 0.75	.014*
(min–max)	(2–5)	(2–5)	(2–5)
median (IQR)	5 (4–5)	4 (4–5)	5 (5–5)
Social competence	Questionnaire item Q18
Mean ± std.dev.	4.17 ± 1.07	4.08 ± 1.09	4.36 ± 1.04	.189
(min–max)	(1–5)	(1–5)	(1–5)
Median (IQR)	4.5 (4–5)	4 (4–5)	5 (4–5)
Practical ability	Questionnaire item Q19
Mean ± std.dev.	4.15 ± 1.1	4.11 ± 1.09	4.24 ± 1.17	.447
(min–max)	(1–5)	(1–5)	(1–5)
Median (IQR)	5 (4–5)	4 (3–5)	5 (4–5)
360 scenario interest	Questionnaire item Q20
Mean ± std.dev.	4.74 ± 0.49	4.75 ± 0.48	4.72 ± 0.54	.861
(min–max)	(3–5)	(3–5)	(3–5)
Median (IQR)	5 (5–5)	5 (5–5)	5 (5–5)
360 scenario extent	Questionnaire item Q21
Mean ± std.dev.	4.74 ± 0.32	4.75 ± 0.59	4.72 ± 0.54	.543
(min–max)	(3–5)	(3–5)	(3–5)
Median (IQR)	5 (5–5)	5 (5–5)	5 (5–5)
My ICT ability	Questionnaire item Q22
Mean ± std.dev.	3.94 ± 0.92	3.77 ± 0.91	4.28 ± 0.84	.024*
(min–max)	(2–5)	(2–5)	(3–5)
Median (IQR)	4 (3–5)	4 (3–4)	5 (4–5)

^a Mann–Whitney test (non-parametric).

Statistical significance: * p < .05.

Abbreviations: IQR: Inter-Quartile Range; ICT: Information and Communication Technology; NA: Not Applicable.

Table 2. Results of students' assessment in January 2021 (video 360 scenarios employed) and January 2020 (on-site teaching, including manikin simulations; no video scenarios).

Variable	Total	Female	Male	p-value^a
2021: AssessTotal45	n = 79	n = 53	n = 26
Mean ± std.dev.	39.371 ± 8.07	40.31 ± 7.4	39.31 ± 8.06	.804
(min–max)	(9–45)	(11–45)	(9–45)
Median (IQR)	42 (40–45)	43 (41–44)	42 (37–45)
2021: Grade for oral/practical assessment	n = 79	n = 53	n = 26
Mean ± std.dev.	9.53 ± 1.15	9.73 ± 0.918	9.27 ± 1.34	.099
(min–max)	(5–10)	(5–10)	(5–10)
Median (IQR)	10 (10–10)	10 (10–10)	10 (9–10)
2021: MCQ (%)	n = 77^b	n = 51^b	n = 26
Mean ± std.dev.	92.52 ± 4.57	92.31 ± 4.58	92.96 ± 4.61	.548
(min–max)	(79–99)	(80–99)	(79–99)
Median (IQR)	94 (91–95)	93 (89.5–95.5)	94 (92–95)
2021: Correlation between AssessTotal45 and Grade for oral/practical assessment: R = 0.665 (p < .001)
2021: Correlation between MCQ and Grade for oral/practical assessment: R = 0.279 (p = .014)
2020: Grade for oral/practical assessment	n = 78	n = 61	n = 17
Mean ± std.dev.	8.7 ± 0.98	8.7 ± 0.95	8.71 ± 1.1	.682
(min–max)	(6–10)	(6–10)	(6–10)
Median (IQR)	9 (8–9)	9 (8–9)	9 (9–9)
2020: MCQ (%)	n = 78	n = 61	n = 17
Mean ± std.dev.	76.67 ± 18.77	78 ± 17.96	71.76 ± 21.28	.271
(min–max)	(40–100)	(40–100)	(40–100)
Median (IQR)	80 (60–90)	80 (60–90)	70 (60–90)
2020: Correlation between MCQ and Grade for oral/practical assessment: R = 0.534 (p < .001)

Grade-related assessments were similar in the two examination sessions, with a supplementary assessment in 2021, based on the nine explicit 5-point criteria (AssessTotal45).

^aMann–Whitney test (non-parametric).

^bTwo female students sat the MCQ examination in a formal setting different from their colleagues and were not included in this statistic.

Abbreviations: IQR: Inter-Quartile Range; MCQ: Multiple Choice Questionnaire; R: Spearman coefficient of correlation (non-parametric).

Table 3. Matrix of the coefficients of correlation for the nine explicit five-point criteria employed in the independent assessment during the interview-based oral/practical evaluation.

N = 79 students in total		Patient evaluation	Integrated thought process	Diagnosis	Differential diagnosis	Investigation plan	Treatment	CPR algorithm	Descriptive procedure	ECG interpretation
Patient evaluation	R	1.000	.458**	.501**	.510**	.525**	.450**	.471**	.231*	.230*
	p	.	<.001	<.001	<.001	<.001	<.001	<.001	.041	.042
Integrated thought process	R	.458**	1.000	.407**	.375**	.453**	.523**	.476**	.541**	.529**
	p	<.001	.	<.001	.001	<.001	<.001	<.001	<.001	<.001
Diagnosis	R	.501**	.407**	1.000	.877**	.751**	.568**	.536**	.395**	.506**
	p	<.001	<.001	.	<.001	<.001	<.001	<.001	<.001	<.001
Differential diagnosis	R	.510**	.375**	.877**	1.000	.864**	.590**	.531**	.403**	.522**
	p	<.001	.001	<.001	.	<.001	<.001	<.001	<.001	<.001
Investigation plan	R	.525**	.453**	.751**	.864**	1.000	.668**	.591**	.406**	.499**
	p	<.001	<.001	<.001	<.001	.	<.001	<.001	<.001	<.001
Treatment	R	.450**	.523**	.568**	.590**	.668**	1.000	.736**	.484**	.555**
	p	<.001	<.001	<.001	<.001	<.001	.	<.001	<.001	<.001
CPR algorithm	R	.471**	.476**	.536**	.531**	.591**	.736**	1.000	.424**	.572**
	p	<.001	<.001	<.001	<.001	<.001	<.001	.	<.001	<.001
Descriptive procedures	R	.231*	.541**	.395**	.403**	.406**	.484**	.424**	1.000	.697**
	p	.041	<.001	<.001	<.001	<.001	<.001	<.001	.	<.001
ECG interpretation	R	.230*	.529**	.506**	.522**	.499**	.555**	.572**	.697**	1.000
	p	.042	<.001	<.001	<.001	<.001	<.001	<.001	<.001	.

Statistically significant values of coefficients R over 0.6 were marked in bold.

Statistical significance: * p < .05; ** p < .01.

Abbreviations: CPR: Cardio-Pulmonary Resuscitation; ECG: electrocardiogram; p: statistical significance; R: Spearman coefficient of correlation (non-parametric).

Data availability statement

Additional data are available upon reasonable request.