Combination of Teddy Bear Hospital and Virtual Reality Training increases empathy of medical students

Excellent communication is essential for health professionals working with children. Teddy Bear Hospital (TBH) is an innovative method of developing paediatric communication skills in health-care students. By exploring the child's perspective of medical students' communication at the TBH, we sought to better understand the role TBH plays in the development of the communication skills in medical students. Semi-structured interviews were conducted with 31 children, aged 3-8 years old, who were attending a TBH run by third year medical students at the Royal Children's Hospital in Melbourne. These interviews were recorded and transcribed after which themes were generated by inductive content analysis using the programme NVivo 12. Children used mostly positive language when describing interactions with teddy doctors. However, almost half of the children could not recall the medical students explaining why their teddy was sick or how their teddy would get better. Furthermore, many teddies returned from TBH with medical issues different to their initial presentation. The communication described at TBH was overwhelmingly positive with children describing little difference between medical students and actual doctors. However, the mismatch in teddy medical issues before and after a visit to TBH along with the lack of understanding on teddy health management plans, suggests the need for further evidence-based training in communication skills for medical students to improve their ability to communicate with very young children.

Introduction: This is a part of a bigger study entitled “Exploring the Views of Healthcare Practitioners on the Teddy Bear Hospital (TBH) as a Personal Safety Module Towards Prevention of Child Sexual Abuse (CSA): A Qualitative Study”. TBH is a make-believe-play hospital utilising soft toys to demonstrate a pretend clinical setting with the aim to educate children on health issues. Studies has shown its effectiveness and reducing anxiety towards the hospital setting and increasing health-related knowledge. IMAM Children’s and Teen Super teen (IMACATS) is one of the non-governmental organisations (NGO) which has adopted this concept to tailor to the local community. The volunteers are healthcare practitioners who are engaged with children in their practice.Objective: To explore the views of healthcare professional towards TBH by IMACATS in Malaysia.Methods: In-depth qualitative audio recorded interviews were conducted with a purposive sample of 18 healthcare professionals. The data obtained were transcribed and analysed thematically.Results: Three themes were derived from the interviews: i) Awareness of the TBH concept. Seven participants have volunteered in TBH previously. However, there was a speculation that many doctors are still unknowing of this concept. ii) Benefits of TBH. This includes reducing children’s anxiety, changing children’s presumption on healthcare, increasing children’s health knowledge and encouraging healthy behaviour and bridging the gap between the public and healthcare. iii) Suggestion of Module for future TBH: (a) More school-based programmes should be organised in addition to hospital and community based; (b) Ministry of Health (MOH) should encourage children health screening using this concept; (c) A module for hospitalised children should be conducted.Conclusion: Participants interviewed suggested for TBH to be organised in a wider scale as it is an approachable concept for educating children. There are many ways in which it can benefit this community.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S18

The Teddybear Hospital (TH) Project is an effort to increase children's knowledge and decrease their anxiety. It is also intended to improve medical students' pediatric communication skills. This study evaluated the educational effects on participating preschool children and medical students. Preschool children were offered to bring their stuffed toys to the TH at our tertiary academic medical center. Medical students who had completed the pediatric surgery rotation staffed the TH, performed examinations, and interacted with the children. The children's knowledge of anatomy, medical equipment, and healthy lifestyle, along with their level of anxiety towards hospitalization, was assessed using preinterventional and postinterventional validated survey tools. Preschool peers who did not participate in the TH served as controls. Participating medical students were tested on professionalism and pediatric surgical knowledge during, and 3 weeks after the intervention, and compared to their nonparticipating peers. A total of 131 children (63 intervention, 68 control) and 48 medical students (16 intervention, 32 control) participated in the study. Children's state anxiety decreased by 0.98 points (95% CI: -0.3 to -1.8, P <0.001), while knowledge increased significantly on 'healthy lifestyle' by 1.4 points (95% CI: 1.01-1.79, P <0.05), on 'medical equipment' by 4.5 points (95% CI: 3.8-5.2, P <0.0001), and on 'anatomy' by 5.05 points (95% CI: 4.73-5.73, P <0.01). No changes were detected in any of the outcome measures in the control group. Medical students' objective professionalism increased by 4.2 points (95% CI: 1.58-6.80, P <0.01) compared to nonparticipant medical students. The tests did not show an increase in the medical students' pediatric surgical knowledge. Preschool participation in a TH increased knowledge and decreased anxiety regarding hospitalization and medical personnel. It also helped medical students to playfully acquire medical professionalism.

Introduction: Teddy Bear Hospital is a strategy used to help reduce children’s fears of the healthcare system and teach them about health-related issues. It involves mock consultations where medical students play the role of a “teddy doctor” and children act as the carer of teddy, or another soft toy, requiring consultation. This provides medical students with the opportunity to interact with children and develop communication skills while children are introduced to the medical consultation process. The aim of this study was to evaluate the medical student experience of Teddy Bear Hospital as part of a paediatric curriculum.Methods: We conducted a qualitative observational study using observations and focus group interviews with third-year postgraduate medical students. Strategies for engaging children and medical student behaviours were observed. In focus groups, students discussed their experience and the benefits of involvement they perceive. Inductive content analysis was performed, guided by a phenomenological approach, to identify themes.Results: Three major themes were identified: student discomfort, adapting communication to child temperament and developmental age and how the Teddy Bear Hospital contextimpacts learning. Students experienced discomfort approaching families and through disclosure of medical information. Despite this, students described it as an enjoyable learning experience that taught them to adapt communication to the child. Students also recognised greater challenges in a hospital-based event than one in the community.Conclusions: Participation in Teddy Bear Hospital appears to be a valuable component of the paediatric curriculum for medical students. Through enjoyable experiential learning, students described developing important communication skills with children. While they did experience discomfort in the process, this has potential to deepen learning.

The 'Teddy Bear Hospital' is a medical students' project, which has been increasingly established in many countries. To evaluate this concept, we examined the effects of a German Teddy Bear Hospital on children's knowledge relating to their body, health and disease. Using a quasi-experimental pre/post design, we examined 131 preschool children from 14 German kindergartens with pictorial interview-based scales. The analysis of covariance revealed that the children who visited the Teddy Bear Hospital had a significantly better knowledge concerning their body, health and disease than the children from the control group. This German Teddy Bear Hospital is a good health education vehicle for preschool children.

The Joyce and Irving Goldman School of Medicine, Faculty of Health Sciences at the Ben Gurion University of the Negev encourages students to take part in the development and evaluation of the teaching experience. These special relations between the school and the students contribute not only to changes in the curriculum but also to increased involvement of faculty and students in the community. This article reviews the special relationship between the Faculty of Health Sciences and its medical students through the Medical Students Association (ASRN). During the last decade, BGU medical students have initiated innovative programmes some of which have recently become integrated into the curriculum. These include: prevention of sexual violence among youth, decreasing white-coat fear in small children ('Teddy Bear hospital' and participation in home-hospice activities. By encouraging students to become equal partners in faculty development and rejecting the traditional paternalistic mode of teacher-student relationships, the faculty has created an improved learning experience, and increased student motivation and levels of communication between the teachers and the future clinicians.

Objective: The Teddy Bear Hospital (TBH) is a worldwide concept of imaginative play therapy. TBH was initiated to address children’s fear andanxiety towards healthcare setting. Children will bring their teddy bears to see the “teddy doctor” and will act as the parents or guardians while observing the main aim of a clinic or hospital visit. This study aims to evaluate the effectiveness of the IMACATS’ TBH intervention module on reducing children’s anxiety towards healthcare professionals. Methods: A pretest-posttest pre-experimental study was conducted in from May to December 2022. Participants were among primary school students in Selangor. This study was approved by Ministry of Education and informed consents were obtained from parents prior to recruitment. 45 participants were recruited with the help of teachers. There were two assessment points, one month before (preintervention) and one week after TBH event (post intervention). The same questionnaire was used at those two points. Study instruments consisted of two sections (sociodemographic background and level of anxiety towards healthcare professionals using Visual Analogue Scale (VAS) with 6-point Likert scale. Data will be analyzed using SPSS version 26.To evaluate the effectiveness of TBH, mean scores will be compared between pre and post intervention. Results &amp; Conclusion: 45 participants were recruited with the help of teachers but only 40 completed the questionnaire. Majority were female (60%) and from low socioeconomic status (45%). All participants were Malay. The mean scores for each item of level of anxiety towards healthcare personnel range from 1.73 to 4.0 for pre-intervention and 1.05 to 3.28 for post-intervention. The total mean score of anxiety level for pre- and post-intervention also reduced from 10.13±3.22 to 7.50±2.31 respectively. Hence, we can conclude that TBH is effective in reducing anxiety level of children towards healthcare setting. International Journal of Human and Health Sciences Supplementary Issue 01: 2024 Page: S51

Background: An increase of sedentary behavior was observed in each year especially in clinical year. This accounts for a decrease in physical activities (PAs) of medical students, which could lead to reduced overall health and physical performance. Objective: To compare the levels of PA between pre-clinical and clinical medical students of Mae Fah Luang University (MFU) and to explored association between the levels of PA and school year. Materials and Methods: A cross-sectional study was conducted between May and August 2019. Online questionnaire, including personal profiles and global PA questionnaire, were distributed to all MFU medical students currently studying in the academic year of 2019. Results: One hundred fifty-six medical students participated in the present study. From the questionnaires, 67.74% of pre-clinical medical students (n=63) and 52.99% of clinical medical students (n=36) had moderate to high levels of PA. Pre-Clinical students had significantly higher levels of PA by median metabolic equivalent value (MET) at 1,908.73 versus 1,339.05 MET-minutes/week (p=0.03). The sixth-year medical students increased risk of lower PA than the first year about 8.34 times (p&lt;0.01). Conclusion: One-third of the medical students reported as having low levels of PA. Clinical medical students had reduced levels of PA compared to pre-clinical medical students. Therefore, PA should be promoted to help increase the overall health of medical students. Keywords: Physical activity; Metabolic; Equivalent; Medical Student; Clinic; Pre-clinic

This study compares the level of empathy of medical students with the levels of empathy among other university students. It also explores the impact of the psychiatric clerkship with group experience on the medical students' empathy for and attitudes toward mental patients as compared with the level of attitudes and empathy of medical students without group experience. The results indicated that psychiatric teaching can change and enhance empathy and increase positive attitudes toward mental illness among medical students. These results were dependent upon the students' participation in a self-exploratory group experience. An additional goal of the study was to test the impact of medical students' psychiatric clerkships on the relationship between the level of self-reported empathy and the level of empathy as judged by their peer group. It was found that these separate vantage points merged as a consequence of group participation.

Potential attributes of virtual reality (VR) can be a breakthrough in the improvement of sudden cardiac arrest (SCA) training. However, interference with the virtual world is associated with the need of placing additional equipment on the trainee's body. The primary aim of the study was to evaluate if it does not affect the quality of chest compressions (CCs).91 voluntarily included in the study medical students participated twice in the scenario of SCA – Traditional Scenario (TS) and Virtual Reality Scenario (VRS). In both cases two minutes of resuscitation was performed.If VRS was the first scenario there were significant differences in CCs depth (VRS - Me = 47 mm [IQR 43 – 52] vs TS - Me = 48 mm [IQR 43 – 55]; P = .02) and chest relaxation (VRS - Me = 37% [IQR 5 – 91] vs TS - Me = 97% [IQR 87 – 100]; P < .001). 97.8% of respondents believe that training with the use of VR is more effective than a traditional method (P < .01). Most of the study group (91%, P < .01) denied any negative symptoms during the VR scenario.Virtual reality can be a safe and highly valued by medical students, method of hands-on CPR training. However additional VR equipment placed on the trainee's body may cause chest compressions harder to provide. If it is not preceded by traditional training, the use of VR may have an adverse impact on depth and full chest relaxation during the training. To make the best use of all the potential that virtual reality offers, future studies should focus on finding the most effective way to combine VR with traditional skill training in CPR courses curriculum.

ObjectivesChronic pain, particularly when undiagnosed, is often misunderstood by clinicians due to its invisible and subjective nature. This study aimed to design and evaluate a narrative-driven Virtual Reality (VR) experience that immerses medical students in the fragmented reality of a patient living with undiagnosed chronic pain. The project seeks to bridge the empathy gap in clinical training for medical students and healthcare professionals while enhancing understanding of patient experiences.MethodsWe developed a 4-minute immersive VR experience. Seventy undergraduate medical and health professional students with prior clinical exposure to chronic pain patients participated in the study. Following the experience, participants completed two questionnaires: one assessed the usability and validity of the VR application, while the other evaluated the medical students’ empathy and learning outcomes through a comparative analysis of post-experience surveys.ResultsThe SUS score was 70.13 ± 7.38, suggesting an above-average evaluation of the system’s usability and maturity. VR-experienced participants showed significantly better comprehension of chronic pain’s daily impacts and stronger emotional resonance with patient suffering. Additionally, the students in VR-experienced group rated the tool higher for its effectiveness in fostering empathy and improving knowledge retention.ConclusionOverall, the VR experience achieved the expected outcomes, with students identifying it as an immersive and impactful educational tool. It holds promise for enhancing empathy in clinical training, such as regarding undiagnosed chronic pain, potentially improving diagnosis and treatment approaches. While the results underscore VR’s potential to humanize chronic pain education, future studies should include longitudinal assessments, expanded narratives that reflect diverse patient experiences, and opportunities for users to engage with multiple scenarios, thereby better representing the full spectrum of challenges in many diseases.

The content of the article provides a detailed analysis of the contextual premises that underlie the formation of medical empathy. These premises include the regulatory documents in the medical field, educational curriculum, and the actual level of empathy exhibited in medical practice. They serve as the foundation for understanding the necessity and significance of medical empathy in the doctor-patient relationship and for cultivating empathic skills among future healthcare professionals. The QMEE (Questionnaire Measure of Emotional Empathy) serves as a valid and efficient tool for assessing the level of empathy in medical students. By utilizing the QMEE questionnaire in alignment with the aforementioned contextual premises, it becomes possible to evaluate not only the level of empathy but also how these premises influence and shape the development of empathic abilities, identifying areas in need of improvement. Furthermore, this connection offers a comprehensive approach to comprehend the process of developing medical empathy in students. The two elements, contextual premises and the QMEE questionnaire, collaborate to provide a detailed perspective on the level of empathy among students and to pinpoint specific areas requiring interventions and enhancements, thereby supporting the development of empathic skills. This integrative approach between contextual premises and the QMEE questionnaire represents a pivotal instrument in evaluating and enhancing the process of cultivating medical empathy among future healthcare professionals.

Worldwide studies have reported a drastic increase in child sexual abuse (CSA) involving very young children. In Malaysia, several attempts have been made to combat this problem via educational programs. Teachers have reported a lack of confidence in teaching this topic; hence a less threatening approach is needed. The Teddy Bear Hospital (TBH) is an innovation whereby the children bring their teddies while visiting the volunteers assuming healthcare practitioners’ role. This execution is effective in reducing the children’s anxieties about hospitalization and increasing their health knowledge. Therefore, our objective is to explore healthcare practitioners’ (HCP) views for the content of TBH and its approach as a personal safety module toward preventing CSA. Eighteen in-depth-interviews were conducted. Interviews were thematically analyzed. Participants suggest the TBH method as a good approach to teaching prevention of CSA among preschoolers. Four main themes emerged from this study: (1) educating children about personal safety, (2) moral values and faith as a medium to prevent child sexual abuse, (3) addressing social media use in children, and (4) general approach to content delivery. The involvement of parents is crucial. Addressing moral values and faith and usage of social media platforms are also essential factors to look into.

Background: Empathy is an indispensable skill in medicine and is an integral part of ‘professionalism’. Yet, there is still increasing concern among medical educators and medical professionals regarding the decline in medical students’ empathy during medical education.Aims: This article aims at comparing the levels of empathy in medical school students across the different years of undergraduate medical education. It also aims at examining differences in empathy in relation to gender, year of study, cultural and religious backgrounds, previous tertiary education and certain programmes within the curriculum.Method: The Jefferson Scale of Physician Empathy, Student version (JSPE-S) was employed to measure empathy levels in medical students (years one to five) in a cross-sectional study. Attached to the scale was a survey containing questions on demographics, stage of medical education, previous education, and level of completion of particular programmes that aim at promoting personal and professional development (PPD).Results: Four hundred and four students participated in the study. The scores of the JSPE-S ranged from 34 to 135 with a mean score of 109.07 ± 14.937. Female medical students had significantly higher empathy scores than male medical students (111 vs. 106, p < 0.001) across all five years of the medical course. There was no significant difference in the total empathy scores in relation to year of medical education. Yet, the highest means were scored by year five students who had completed personal and professional development courses.Conclusions: Our findings suggest that there is a gender difference in the levels of empathy, favouring female medical students. They also suggest that, despite prior evidence of a decline, empathy may be preserved in medical school by careful student selection and/or personal and professional development courses.

BackgroundToday’s medical students are the future physicians of people living with HIV/AIDS (PLWHA). It is therefore essential that medical students possess the appropriate knowledge and attitudes regarding PLWHA. This study aims to evaluate knowledge and attitudes of pre-clinical Israeli medical students and to assess whether their knowledge and attitudes change throughout their pre-clinical studies.MethodsA cross-sectional study was conducted among all pre-clinical medical students from the four medical schools in Israel during the academic year of 2010/2011 (a total of 1,470 students). A self-administered questionnaire was distributed. The questionnaire sought student responses pertaining to knowledge of HIV transmission and non-transmission routes, basic knowledge of HIV/AIDS treatment and attitudes towards HIV/AIDS.ResultsThe study’s response rate was 62.24 percent. Knowledge among pre-clinical medical students was generally high and showed a statistically significant improvement as students progressed through their pre-clinical studies. However, there were some misconceptions, mostly regarding HIV transmission via breastfeeding and knowledge of HIV prevention after exposure to the virus. Students’ attitudes were found to include stigmatizing notions. Furthermore, the majority of medical students correlated HIV with shame and fear. In addition, students’ attitudes toward HIV testing and providing confidential medical information were contradictory to health laws, protocols and guidelines. Overall, no positive changes in students’ attitudes were observed during the pre-clinical years of medical school.ConclusionThe knowledge of pre-clinical medical students in Israel is generally high, although there are some knowledge inadequacies that require more emphasis in the curricula of the medical schools. Contrary to HIV-related knowledge, medical students’ attitudes are unaffected by their progression through medical school. Therefore, medical schools in Israel should modify their curricula to include teaching methods aimed at improving HIV-related attitudes and adherence to medical professionalism.