PASI Training via Virtual Reality Application – new way of effective teaching

INTRODUCTION: Systemic treatment decisions for psoriasis are often initiated and guided depending on the severity of the disease, determined by the validated Psoriasis Area and Severity Index (PASI). Therefore, accurate evaluation of disease severity is crucial. However, exact and reproducible PASI assessment requires training. A VR PASI program could improve empowerment of health care providers and grading accuracy. Aim of this study was to compare the effectiveness of a Virtual Reality (VR) PASI training program to standard PASI teaching. METHODS: In a randomized prospective trial classical lecture and VR program were compared in 70 medical students (study participants) without previous knowledge and training in skin assessment. Effectiveness of training was measured by determining a PASI score in real patients and comparing the results to those of a trained assessor. Furthermore, the rating of quality and satisfaction of both training methods was measured in both educational groups. RESULTS: Both groups were equally interested in dermatology, all study participants had little to no experience with PASI, and both groups had similarly little to no experience in dealing with VR. VR-trained PASI raters achieved better results assessing correct PASI severity compared to those trained via classical lecture (U = 397.5, p = 0.011). The effect size, calculated using Rosenthal´s method, was R = 0.302 (moderate effect). Median difference of PASI score was 1.5 (95% CI 0.3-2.4). Median difference scores of classical lecture group (PASI delta: 2.7) was less accurate than in VR group (PASI delta: 1.1), indicating a potentially clinically relevant effect for median difference (1.5 (95% CI: 0.3-2.4). VR group showed higher accuracy in the application of the PASI and reported both higher satisfaction with the learning unit and better experience in implementing the teaching method. CONCLUSION: In untrained raters PASI Training via the VR program led to higher accuracy in severity assessment compared to a classical lecture.