游戏化与进度条提升虚拟现实模拟中的表现与保持：一项随机对照试验

文献信息

中文摘要

引言： 模拟训练已被确立为培养临床和手术技能的有效方式，但在重复练习中维持学习者的动机仍然具有挑战性。游戏化被提出用于增强参与度，但关于在技术技能模拟中具体且可迁移的游戏化特征的证据有限。本研究探讨了一种游戏化元素——进度条——对基于模拟的外科训练中技能习得与保持的影响。
方法： 一项前瞻性、随机对照试验，纳入24名无颞骨手术经验的医学生。参与者按游戏经验分层，并随机分配至在可见耳模拟器中使用或不使用进度条的虚拟现实模拟训练。受训者在分布式训练项目中完成15例乳突切除术，随后在2.5个月后进行保持测试。表现使用经过验证的、模拟器整合的最终产品评分进行评估。学习和保持结果采用线性混合效应模型进行分析。
结果： 与使用标准学习支持的训练相比，使用进度条的训练在26分量表上表现出显著更高的表现（平均差：1.5分；P < 0.002）。有游戏经验的参与者总体上优于无游戏经验者（平均差：1.4分；P < 0.002），尤其是在训练早期。在无游戏经验者中，该干预显著改善了训练期间的表现（平均差：2.1分；P < 0.002）和保持测试时的表现（平均差：2.5分；P < 0.035），抵消了他们的非游戏劣势。
结论： 进度条是一种有效的游戏化反馈机制，可增强技能习得并支持保持，尤其是对于游戏经验有限的学习者。这一可推广的特征可能提高技术增强的模拟外科教育的可及性和有效性。

英文摘要

INTRODUCTION: Simulation training is established as efficient for developing clinical and surgical skills, yet sustaining learner motivation during repeated practice remains challenging. Gamification has been proposed to enhance engagement, but evidence for specific, transferable gamification features in technical skills simulation is limited. This study investigates a gamification element, progress bars, on skill acquisition and retention in simulation-based surgical training.
METHODS: A prospective, randomized controlled trial involving 24 medical students with no prior experience in temporal bone surgery. Participants were stratified by gaming experience and randomized to virtual reality simulation training with or without progress bars in the visible ear simulator. Trainees completed 15 mastoidectomy procedures in a distributed training program, followed by retention testing after 2.5 months. Performance was assessed using a validated, simulator-integrated final-product score. Learning and retention outcomes were analyzed using linear mixed-effects models.
RESULTS: Training with progress bars resulted in significantly higher performance on a 26-point scale compared with training with standard learning supports (mean difference: 1.5 points; P < 0.002). Participants with gaming experience outperformed non-gamers overall (mean difference: 1.4 points; P < 0.002), particularly in early training. Among non-gamers, the intervention significantly improved performance both during training (mean difference: 2.1 points; P < 0.002) and at retention testing (mean difference: 2.5 points; P < 0.035), offsetting their non-gaming disadvantage.
CONCLUSIONS: Progress bars were an effective gamified feedback mechanism that enhanced skill acquisition and supported retention, particularly for learners with limited gaming experience. This generalizable feature may improve the accessibility and effectiveness of technology-enhanced simulation-based surgical education.