Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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Scientific reports
Impact of a structured case report on self-reported responses to simulated emergency scenarios: a randomized survey-based study
Case reports are a long-standing component of medical research, but their association with self-reported responses to simulated clinical scenarios remains underexplored. This study investigated whether exposure to a structured case report influences simulated emergency medical decisions. This randomized survey-based study was conducted among licensed physicians between March and May 2025. Participants were randomly assigned to an intervention group, which received a structured case report on blunt neck trauma, or a control group, which did not. Both groups subsequently provided self-reported Likert-scale responses to identical simulated emergency scenarios, covering five domains: local trauma consequences, accompanying injuries, diagnostic methods, airway management strategies, and hospital selection. Responses were collected on Likert scales. Group differences were assessed using Mann-Whitney U tests, t-tests, and chi-squared tests; prespecified exploratory subgroup analyses examined the moderating role of clinical experience. Sixty-three participants completed the study. Baseline demographics and qualifications did not differ significantly between groups. Exposure to the case report was associated with statistically significant differences in self-reported responses to simulated scenarios, with the most pronounced associations in airway management strategies (all five items statistically significant, median effect size r = 0.44). Intervention participants assigned higher ratings to maintaining spontaneous breathing and supraglottic airway use, while assigning lower appropriateness to endotracheal intubation and cricothyrotomy. Moderate associations were observed in diagnostic choices (e.g., pathological breath sounds, ultrasound use) and hospital selection (e.g., ECMO availability). No consistent effects were found for local or accompanying injuries. Exploratory stratified analyses revealed that junior physicians (≤ 5 years of practice) appeared more responsive, with significant differences across multiple domains and larger effect sizes (median r > 0.6). In contrast, no statistically significant between-group differences were detected in the senior (> 15 years) subgroup, although this exploratory analysis was limited by small subgroup size. Structured case reports may influence self-reported responses to simulated emergency scenarios, particularly among less experienced clinicians. These findings suggest that the educational impact of case-based learning formats may vary depending on the level of clinical experience, but do not allow conclusions about real-world clinical behavior or patient outcomes. Future work should further investigate adaptive case report formats and their potential integration into emergency medicine training.Trial registration: German Clinical Trials Register (DRKS00038961), registered von 13 January 2026.
27 May 2026
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Immersive virtual reality-assisted anatomy training improves endotracheal intubation performance in simulation: a randomized controlled trial among Chinese non-anesthesiology residents
INTRODUCTION: This study aimed to compare immersive virtual reality (IVR)-assisted versus conventional anatomy training for teaching endotracheal intubation (ETI) to novice non-anesthesiology residents enrolled in China's Standardized Residency Training program. METHODS: A total of 90 non-anesthesiology residents without prior ETI experience were randomly assigned to either an IVR group receiving IVR-assisted anatomy training (n = 45) or a control group receiving conventional anatomy training (n = 45). All participants underwent a standardized teaching protocol. The primary endpoint was residents' ETI performance on a simulator, assessed using both the Global Rating Scale (GRS) and a task-specific checklist. The secondary endpoints included changes in written multiple-choice question (MCQ) scores and residents' evaluations of the course. RESULTS: In practical ETI assessments on a manikin, the IVR group achieved significantly higher scores on the task-specific checklist than the control group (90.34 ± 2.89 vs. 87.20 ± 3.29; p < 0.001), whereas GRS scores were comparable between groups. Both groups showed significant post-training improvement in knowledge scores (p < 0.001), with the IVR group showing a greater gain in theoretical knowledge (54.0% vs. 36.3%; p < 0.001). Participants in the IVR group also expressed a stronger preference for their training method (80.8%) and reported higher levels of motivation, confidence, and enjoyment (all p < 0.05). CONCLUSION: IVR-assisted anatomy training enhances the effectiveness of ETI training for novice non-anesthesiology residents, offering an interactive, engaging, and reproducible approach within China's Standardized Residency Training framework.
5 Apr 2026
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