Impact of an Endovascular Simulator and Video Games on Medical Student Procedural Outcomes and Interventional Radiology Interest

Abstract

Rationale and objectives: To determine if student exposure to an endovascular simulator can increase confidence performing procedures and interest in interventional radiology (IR) and to assess if past and present video game experience confers improved procedural skills.

Materials and methods: This IRB-approved prospective randomized control study evaluated medical student specialty interest and procedural performance on an endovascular stimulator before and after video game simulation. Participating students were required to complete a pre-procedure survey and an initial simulated procedure utilizing an endovascular simulator before being randomized to either a Video Game (VG) or control arm. Students then proceeded to complete a second simulated procedure and a post-procedure survey. Before starting the procedure, a standardized explanation was read to each participant. Students randomized to the VG arm would play a video game within a ten-minute slot between the two procedures, while control arm students would rest. Survey data included demographic information, history of video gaming, confidence performing endovascular procedures, and interest in procedural specialties. Primary outcomes included self-reported procedural confidence and specialty interest on a five-point scale (five being the highest). Secondary outcomes included procedural skill as measured by time to completion during the simulated procedures.

Results: A total of 52 medical students (mean age, 25.9 years; male 58%) participated in this study, with 26 students randomized to the VG arm and the remainder to the control arm. Of the total cohort, 31% (n=16) identified as first year medical students, 31% (n=16) as third year, 23% (n=12) as fourth year, 10% (n=5) as second year, and 6% (n=3) as leave of absence students. The cohort's average confidence performing procedures prior to participation was 2.4 (out of five), interest in procedural specialties was 4.1, and interest in IR was 2.8. After participation in the study, confidence performing procedures rose by 57% to 3.8 (p<0.0001), interest in procedural specialties rose by 8% to 4.4 (p=0.0016), and interest in IR increased by 28% to 3.6 (p<0.0001). The collective cohort improved by an average of 23% between procedure one completion time and procedure two completion time (3 min 56 s to 3 min one second). The differences in the rate of improvement between the VG group and control group was not significant. Gender was found to be the only background variable to significantly correlate with procedural times (p=0.01).

Conclusion: Student confidence performing procedures significantly increased after participating in the study, as did student interest in procedural specialties in general and in IR specifically. A history of video games and prospective VG group participation did not confer procedural skill as measured by time to completion.

Keywords: Endovascular simulation; Interventional radiology education; Medical student procedural confidence; Procedural skills training; Video game experience.