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Aim: Clinical decision making is an essential competence in medical education, as outlined in the National Competence-Based Catalogue of Learning Objectives for undergraduate Medical Education [https://nklm.de/zend/menu]. Modern teaching concepts like Virtual Reality (VR) simulation in an immersive medical setting are used to teach medical students not only about a disease but also train clinical decision making. In the study, we investigated long-term impacts of VR simulation on Clinical Decision-Making and knowledge Retention.

Methods: During one academic year, fourth-year medical students could participate in facultative VR simulation as part of the internal medicine curriculum. As preparation, a blended learning module with a short assessment had to be completed. During the half-hour immersive simulation at the MHH SkillsLAB, students were evaluated and given feedback regarding their clinical decision-making skills. Students had to complete an online reflexional exercise afterwards. In the following year, these students completed an OSCE, assessing clinical decision-making skills.

Results: 125 (43,6%) fourth year medical students took part in the VR simulation. Of those, 20 students were tested at the matching OSCE station, additionally 49 students were also tested without VR simulation. In the matching OSCE station, the students with previous VR simulation performed significantly better than those without (p=0.0488). In addition, students with previous VR simulation were significantly better in the overall OSCE compared to medical students who did not participate in VR simulation (mean 281.96 (SD 49.26) vs. 262.61 (SD 48.91) points) (p=0.0019).

Discussion: New teaching methods such as immersive VR training can improve medical students’ overall clinical decision-making outcomes and lead to a long-term increase in recall of the disease taught. Although few participants and one year after the intervention, this study hints to a possible benefit of VR simulation on clinical decision making and knowledge retention.

Take home messages:

• Medical students participating in VR performed significantly better in the OSCE stations with clinical decision making.
• New teaching methods such as VR need practical standardized evaluation in addition to subjective assessment.