目的 探讨基于增强现实(augmented reality,AR)技术的功能磁共振成像(functional magnetic resonance imaging, fMRI)融合重建在临床医学专业实习生医学影像学教学中的应用效果。方法 选取2023年6月至8月在华中科技大学同济医学院学习的2019级五年制临床医学专业40名实习生为研究对象,采用简单随机法分为试验组和对照组,每组20名。试验组采用AR技术辅助的fMRI融合重建教学系统开展医学影像学教学,对照组采用传统教学方式进行医学影像学教学。采用自编问卷对两组实习生进行教学效果评价调查,包括学习兴趣程度和认知负荷。另外对试验组实习生进行新教学模式接受度调查。采用独立样本t检验、卡方检验、Pearson相关分析、描述性统计等方法分析数据。结果 在兴趣程度上,试验组实习生对知识兴趣度提升评分(4.10±0.79)分、学习主动性提高评分(3.85±0.75)分、联系性思考评分(3.95±1.05)分等均高于对照组的(3.35±0.61)分、(3.35±0.67)分、(3.20±0.62)分。在认识负荷上,试验组实习生对掌握三维想象能力难易评分(4.70±0.47)分、课程轻松度评分(4.35±0.49)分、课程印象评分(4.05±0.89)分等均高于对照组的(2.70±0.47)分、(3.20±0.62)分、(3.15±0.59)分。以上对比差异均具有统计学意义(均P＜0.05)。试验组实习生的学习兴趣与认知负荷间存在更多正向相关性 (r=0.58~0.81,均P<0.05)。16名(80.0％)试验组实习生乐意接受AR辅助的新教学模式。结论 与传统教学方式相比,基于AR的fMRI融合重建教学能够显著提高实习生学习兴趣,降低认知负荷,并获得较高接受度,具有较好的教学应用潜力。
Objective To explore the application and effectiveness of augmented reality (AR)-assisted functional magnetic resonance imaging (fMRI) fusion reconstruction in medical imaging teaching for clinical medicine interns. Methods Forty interns majoring in five-year clinical medicine of the 2019 grade from Tongji Medical College of Huazhong University of Science and Technology were enrolled from June to August 2023. Participants were randomly divided into an experimental group (n=20) and a control group (n=20). The experimental group received medical imaging instruction utilizing an AR-assisted fMRI fusion reconstruction teaching model, whereas the control group received traditional medical imaging education. A self-designed questionnaire was used to evaluate students′ learning interest and cognitive load in both groups, with an additional acceptance survey of the AR-assisted teaching model for the experimental group. Independent sample t-test, chi-square test, pearson correlation analysis and descriptive statistical analysis were used to analyze the data. Results In terms of the degree of interest, the scores ofthe improvement of knowledge interest, the improvement of learning initiative, and the associative thinkingin the experimental group were (4.10±0.79), (3.85±0.75), and (3.95±1.05),respectively. They were all higher than those in the control group (3.35±0.61), (3.35±0.67), and (3.20±0.62). In terms of cognitive load, the scores of the difficulty of mastering three-dimensional imagination ability, the course easiness, and the course impression in the experimental group were (4.70±0.47), (4.35±0.49), and (4.05±0.89), respectively. They were all higher than those in the control group (2.70±0.47), (3.20±0.62), and (3.15±0.59). All differences were statistically significant (all P<0.05). In the experimental group, there were more positive correlations between learning interest and cognitive load (r=0.58-0.81, all P<0.05). Eighty percent of the interns in the experimental group were willing to accept the new AR assistance teaching model. Conclusions Compared with traditional teaching methods, the AR-assisted fMRI fusion reconstruction teaching significantly enhances students′ interest, reduces cognitive load, and achieves high acceptance among students, indicating its considerable value for medical imaging education.
[1] 徐田野, 梁洪生, 姚凯, 等. 增强现实和混合现实技术在神经外科领域的应用[J]. 临床神经外科杂志,2019,16(4):356-359. DOI:10.3969/j.issn.1672-7770.2019.04.016.
[2] Hou BL, Bhatia S, Carpenter JS.Quantitative comparisons on hand motor functional areas determined by resting state and task BOLD fMRI and anatomical MRI for pre-surgical planning of patients with brain tumors[J]. Neuroimage Clin, 2016,11:378-387. DOI:10.1016/j.nicl.2016.03.003.
[3] 张毓婧. 磁共振功能成像在脑胶质瘤诊断中的研究进展[J]. 医学综述,2016,22(9):1738-1741. DOI:10.3969/j.issn.1006-2084.2016.09.021.
[4] 赵焕, 白岩, 王梅云. 多模态磁共振成像技术在脑胶质瘤基因分型及预后评估中的研究进展[J]. 磁共振成像,2021,12(9):98-102.DOI:10.12015/issn.1674-8034.2021.09.025.
[5] Berntsen EM, Gulati S, Solheim O, et al.Functional magnetic resonance imaging and diffusion tensor tractography incorporated into an intraoperative 3-dimensional ultrasound-based neuronavigation system: impact on therapeutic strategies, extent of resection, and clinical outcome[J]. Neurosurgery, 2010,67(2):251-264. DOI:10.1227/01.NEU.0000371731.20246.AC.
[6] 王乐, 赵凌倩. 血氧水平依赖功能磁共振成像联合扩散张量成像技术在脑肿瘤外科治疗中的价值[J]. 中西医结合心脑血管病杂志,2020,18(15):2537-2544. DOI:10.12102/j.issn.1672-1349.2020.15.042.
[7] Gulati S, Berntsen EM, Solheim O, et al. Surgical resection of high-grade gliomas in eloquent regions guided by blood oxygenation level dependent functional magnetic resonance imaging, diffusion tensor tractography, and intraoperative navigated 3D ultrasound[J]. Minim Invasive Neurosurg, 2009,52(1):17-24. DOI:10.1055/s-0028-1104566.
[8] 胡惠贞. 增强现实技术在影像学专业循环系统解剖教学中的应用[J]. 齐齐哈尔医学院学报,2019,40(17):2206-2209. DOI:10.3969/j.issn.1002-1256.2019.17.039.
[9] 张晓丽, 李丽娟, 王望, 等. 临床疾病短视频在基础医学教学中的应用[J]. 医学教育管理,2022,8(z1):91-95.DOI:10.3969/j.issn.2096-045X.2022.S1.023.
[10] 梁晨, 李扩, 牛晨, 等. 多模态影像融合+增强现实技术在神经外科住院医师规范化培训PBL教学中的应用[J]. 中国医学教育技术,2022,36(1):88-91,106. DOI:10.13566/j.cnki.cmet.cn61-1317/g4.202201019.
[11] 曾宁, 车晨昊, 杨静, 等. 数字智能化诊疗技术在肝胆外科教学中的应用[J]. 中国继续医学教育,2021,13(9):38-42. DOI:10.3969/j.issn.1674-9308.2021.09.011.
[12] 陈忠仪, 刘宇清, 何炳蔚, 等. 基于混合现实的侧脑室穿刺训练系统在医学教育培训中的应用[J]. 创伤与急诊电子杂志,2019,7(1):5-10. DOI:10.16746/j.cnki.11-9332/r.2019.01.002.
[13] 李加, 张欣. 混合现实技术在护理教学中的应用及展望[J]. 护理学杂志,2021,36(20):110-113. DOI:10.3870/j.issn.1001-4152.2021.20.110.
[14] 马双. 混合现实技术在医学教育中的应用[J]. 中国教育技术装备,2020(9):101-102,107. DOI:10.3969/j.issn.1671-489X.2020.09.101.
[15] Cercenelli L, De Stefano A, Billi AM, et al. AEducaAR, anatomical education in augmented reality: a pilot experience of an innovative educational tool combining AR technology and 3D printing[J]. Int J Environ Res Public Health, 2022,19(3):1024. DOI:10.3390/ijerph19031024.
[16] Baratz G, Sridharan PS, Yong V, et al.Comparing learning retention in medical students using mixed-reality to supplement dissection: a preliminary study[J]. Int J Med Educ, 2022,13:107-114. DOI:10.5116/ijme.6250.0af8.
[17] George O, Foster J, Xia Z, et al. Augmentedreality in medical education: a mixed methods feasibility study[J]. Cureus, 2023,15(3):e36927. DOI:10.7759/cureus.36927.
[18] Marsh HW. SEEQ:a reliable, valid, and useful instrument for collecting students′ evaluations of university teaching[J]. Brit J Educ Psychol, 1982,52(1):77-95 DOI:10.1111/j.2044-8279.1982.tb02505.x.
[19] 董晓军, 陈宗桂, 杜红梅, 等.虚实结合的实践教学模式在磁共振检查技术教学中的应用及效果分析[J]. 高教学刊,2020(18):114-116. DOI:10.19980/j.cn23-1593/g4.2020.18.032.
[20] 张业森, 尚毓淳, 韩易. 多模态影像融合联合增强现实技术在神经外科临床教学中的应用[J]. 淮海医药,2024,42(4):433-436. DOI:10.14126/j.cnki.1008-7044.2024.04.026.
[21] 王瑞雪, 付玲玲, 赵晓瑜. 基于建构主义的AR教学在骨科护生带教中的应用[J]. 齐鲁护理杂志,2023,29(24):69-72. DOI:10.3969/j.issn.1006-7256.2023.24.021.
[22] 唐茁栋, 李亭燕, 王应兵, 等.AR技术在骨科临床教学中的应用[J]. 中国继续医学教育, 2023,15(12):56-60.DOI:10.3969/j.issn.1674-9308.2023.12.013.
[23] Stepan K, Zeiger J, Hanchuk S, et al. Immersive virtual reality as a teaching tool for neuroanatomy[J]. Int Forum Allergy Rhinol, 2017,7(10):1006-1013. DOI:10.1002/alr.21986.
[24] Moro C, Štromberga Z, Raikos A, et al. The effectiveness of virtual and augmented reality in health sciences and medical anatomy[J]. Anat Sci Educ, 2017,10(6):549-559. DOI:10.1002/ase.1696.
[25] Ma LN, Peng R, Xu JJ, et al.Naked eye three-dimensional teaching assistant system applied to undergraduate medical imaging education: a pilot study[J]. Anat Sci Educ, 2025,18(2):139-148. DOI:10.1002/ase.2540.
