Interactive 360 video for catheterization-laboratory education in undergraduate cardiology clerkship: a retrospective two-period crossover study

Catheterization-laboratory clerkship currently offers inconsistent learning opportunities and limited access to actual patients. Immersive 360 video is increasingly used in health professions education, but most modules are passive observations. We examined changes in self-rated understanding after an interactive 360 video module during cardiology clerkship, comparing two implementation sequences relative to catheterization-laboratory observation. We conducted a retrospective, non-randomized, quasi-experimental two-period crossover study. We assigned 88 fifth-year medical students to either an interactive-360-video-first group or to a catheterization-laboratory-first group according to their clerkship schedule. This was followed by the other sequence. The module used 360 video recordings of an actual catheterization laboratory, with pointer-based object identification, synchronized headset playback, and real-time monitoring of learners’ gaze. Self-rated understanding (mean of 10 items; 1–5) was measured at baseline, after the first session, and after the second session. Post-session scores were analyzed with a linear mixed-effects model adjusted for baseline and period. Fifty-one students completed both sessions and all assessments (interactive-360-video-first, n = 28; catheterization-laboratory-first, n = 23). Baseline scores were comparable (2.70 ± 0.56 vs. 2.52 ± 0.83; p = 0.37). After the first session, the interactive-360-video-first group scored higher (4.34 ± 0.58 vs. 3.41 ± 0.92; p < 0.001), whereas after both sessions the groups converged (4.45 ± 0.53 vs. 4.41 ± 0.60; p = 0.80). In the mixed-effects model, post-session understanding was higher after the immersive video module than after catheterization-laboratory observation (adjusted difference, 0.44 points; 95% CI, 0.22–0.66; p < 0.001). The catheterization-laboratory session only significantly increased understanding when delivered first, whereas the interactive 360 video session produced significant gains in either order. Our interactive 360 video module was associated with greater early gains in self-rated understanding. Similar modules may complement catheterization-laboratory observation, supporting both preparation and consolidation in cardiology clerkship.