Towards Integrating Virtual Reality into Medical Curricula: A Single Center Student Survey
Round 1
Reviewer 1 Report
The authors describe surprising results from a single-center student survey on the integration of VR in medical education. Despite the Corona pandemic, more than two-thirds of students had no exposure to VR technology. Ultimately, this study highlights the great potential and need for VR in medical education.
1. What is the main question addressed by the research?
What is the experience, perception, and expectation (of medical students at Saarland University, Germany) towards VR in the context of medical education?
2. Do you consider the topic original or relevant in the field? Does it address a specific gap in the field?
I personally consider the topic timely, original and relevant because it is very important to assess the status quo, before any intervention with new technology. We all think, that the digital natives are currently arriving at our universities. The results of the authors clearly demonstrate, that this is a misconception. The digital native have not arrived yet.
3. What does it add to the subject area compared with other published material?
What is really new is, that there are tremendous regional differences in the experience with and interest in VR in medical education.
4. What specific improvements should the authors consider regarding the methodology? What further controls should be considered?
I do not have suggestions for improving the methodology. Of course, one could consider a multicenter study but that was not the intent of the authors. I would not consider further controls.
5. Are the conclusions consistent with the evidence and arguments presented and do they address the main question posed?
The conclusions are consistent with the presented findings and arguments. They address the main question posed.
6. Are the references appropriate?
The references are up to date and appropriate.
7. Please include any additional comments on the tables and figures.
Well done.
Finally, there are only minor optional issues concerning grammar but I could not identify any serious mistakes. I like the article because it presents surprising findings.
The only issue could be the limited number of participants, but this is absolutely in the range one would expect from a single medical school.
Author Response
Dear Reviewer 1,
many thanks for your comments. Please see the attachment for our response.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
The structure of the article is correct and responds to the requirements of the publication, with a clear objective in its statement but with an answer that could potentially be known before conducting the survey.
In the development of the work, I would highlight two elements that condition it in terms of results:
1- 67.4% of the sample has no previous experience with VR
2- 74.39% have experience in gaming, not in higher education or training.
With this sample profile, it is very difficult to validate the results obtained.
In addition, from the methodological point of view, it would be necessary to explain the characteristics of the survey used, its validation process. There is no information about it.
Author Response
Dear Reviewer 2,
many thanks for your comments. Please see the attachment with our responses.
Author Response File: Author Response.pdf
Reviewer 3 Report
Dear Editor,
Thank you for the opportunity to review this article. I believe that research supporting the idea regarding the “collaboration of technology and medical education” is always needed in medical education, anatomy, and surgery. So, as a medical doctor and an anatomist, I read the article with great interest.
Below are my personal views regarding the manuscript…
Title:
1. Clear and descriptive.
Abstract:
1. Provides a summary of the basic elements of the research.
Introduction:
1. Provides a rationale.
2. Indicates the main objective.
Methodology:
1. According to the last sentence of the “2.1 survey and participants” (line 71), it seems as if researchers have not submitted to any ethical commission for their research. It would be offered to the authors to declare the ethical submission process and statement that implies the research has not received any objection to be carried out by the researchers. Or local regulations regarding this kind of research that could be carried out without ethical approval should be disclaimed.
2. Elements (Setting, modality, participants, measurement and assessment, statistical evaluation principles, statistical test used, tools used in research) regarding the methodology seem appropriate and sufficient to explain the study design.
Results:
1. Connecting (referencing) the results (one-by-one or result-by-question) to the supplement S1 (survey questions) (maybe a fashion referencing the question numbers in the survey) throughout the text would be a good idea to follow the results while reading the manuscript and the supplement S1 simultaneously.
2. Given the readers’ first contact with this article, presenting the findings in the same order as the survey questions may ease them to follow and understand the findings. (The order of Figures 1c and 1d could be interchanged.)
3. P-value presented in line 90 is the answer to which question or relation? Relation between the VR experience (1), gender (2), game experience (3) or any two of these three categorization results? A clear statement is needed for this statistically significant finding.
4. P-value presented in line 93 reflects a significant relation between gender and VR experience. But the answer is hidden yet. Which gender has statistically significant VR experience?
5. Similarly to the previous item, just above the p value in line 97 is the answer to which question?
6. Are the significant findings shown in the last line of Table 1 – probably related to my previous two comments – seem unanswered questions? Showing these findings in separate crosstabs with the specific analysis questions presented in the text that I mentioned in #4 and #5 may increase the understanding of the findings.
7. The commentary in the “comments” column in Table 1 could be removed. The commentary regarding the findings presented in Table 1 could be transferred to the discussion section.
8. What is the contextual integrity of the sentence “In addition, study progress also 108 had no influence (p=0.674).” in line 108 with section 3.2?
9. Finding similar to one in line 110 may deserve to be presented in a graph rather than just two-item pie charts similar to Figure 2a. Do Figure 2b reflects the “yes part” of Figure 1a? I believe the usage of pie charts is inefficient. Nested tables could be more descriptive instead of pie charts.
10. Starting with line 126, some proportions of the participants presented probably concerning the clinical subjects. Does a chi-square test show the significant relationship between the proportions (say, in a crosstab row) or the percentage distributions of the crosstab cells?
11. I believe it is better to present findings of similar nature, in similar chart types. Consistency in the visual properties of the chart types may increase understanding. (Figure 3 and Figure 4)
12. I believe the findings in section 3.5 and 3. 6 deserves a table to present the results.
13. For line 170 and the caption of table 2, the term “Likert type” could be preferred rather than the term “Likert scale.”
14. What is the qualitative analysis methodology of the researchers while evaluating the free text answers in section 3.8?
Discussion
1. What are the researchers' opinions regarding their gender findings concerning the references cited in line 190 and line 194?
2. The sentence in line 236: Is this idea based on a reference in the literature or the findings in this research?
3. The sentence in line 239: How can the VR-naive students accept as positive while they are voting more the disadvantages? This sentence must be checked according to the findings in section 3.6 (line 156)
Author Response
Dear Reviewer 3,
many thanks for your detailed comments. Please see the attachment with our responses.
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
You have incorported some changes and the article have improved
Author Response
Thank you very much for your statement. We are glad that our manuscript fulfills your expectations!
Reviewer 3 Report
Dear Authors,
It's my pleasure to review your article. I added some final notes in the comment boxes as replies. Notes can be evaluated either by you or the editorial office. Good luck with your article!
Regards.
Comments for author File: Comments.pdf
Author Response
Dear Reviewer 3,
thank you for your comments. We are glad that we could match most of your expectations within the first round of review. Please see the attachment with answers to your comments of round 2 in the respective pdf-document (comment boxes). Changes in the manuscript are marked accordingly (in turquoise).
Author Response File: Author Response.pdf
