{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:44:49Z","timestamp":1782819889587,"version":"3.54.5"},"reference-count":35,"publisher":"Ubiquity Press, Ltd.","issue":"1","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Ministry of Science and Technology","award":["MOST 110-2511-H-182-010-MY2"],"award-info":[{"award-number":["MOST 110-2511-H-182-010-MY2"]}]},{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"crossref","award":["BMRP815"],"award-info":[{"award-number":["BMRP815"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Perspect Med Educ"],"abstract":"<jats:p>Introduction: Virtual Reality (VR) has advanced in medical education, offering enhanced realism and immersion, allowing students to safely practice complex and rare scenarios like cancer truth-telling. This study aimed to develop and evaluate the effectiveness of a VR-based cancer truth-telling module.\nMethods: This experimental study randomly assigned fifth-year medical students to the following groups: in-person communication skills training (iCST), VR, and a combined iCST+VR group. The intervention included a 30-minute video-based mini-lecture followed by practical application. The VR group received the VR truth-telling module, the iCST group received the small-class iCST module, and the iCST +VR group received both the iCST and VR modules. Primary outcomes assessed were cancer truth-telling perspectives, with communication confidence and learning satisfaction as a secondary outcome. Data were collected at baseline, immediately after, and at three and six months post-intervention.\nResults: Seventy-nine medical students were enrolled and randomly assigned to the iCST (n = 28), VR (n = 29) and iCST +VR (n = 22) groups. The study findings showed that the iCST+VR group significantly improved in cancer truth-telling perspectives at six months post-intervention. No significant difference was found between iCST and VR groups for cancer truth-telling perspectives. Although communication confidence scores significantly improved across all groups, no differences were found between groups. The iCST group reported higher learning satisfaction compared to other groups, with no significant difference between VR and iCST+VR.\nDiscussion: This study demonstrated that VR is as effective as iCST in enhancing cancer truth-telling perspectives and communication confidence, highlighting VR\u2019s potential as an innovative tool in medical education.<\/jats:p>","DOI":"10.5334\/pme.1684","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T10:39:39Z","timestamp":1757500779000},"source":"Crossref","is-referenced-by-count":1,"title":["Enhancing Cancer Truth-Telling Perspectives Using Virtual Reality in Communication Skills Training: An Experimental Study Among Medical Students"],"prefix":"10.5334","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7521-073X","authenticated-orcid":false,"given":"Shih-Ying","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9223-7106","authenticated-orcid":false,"given":"Ji-Tseng","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2450-4257","authenticated-orcid":false,"given":"Ming-Ju","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9650-5251","authenticated-orcid":false,"given":"Che-Wei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9843-9924","authenticated-orcid":false,"given":"Heng-Hsin","family":"Tung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1639-3390","authenticated-orcid":false,"given":"Maiko","family":"Fujimori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2960-1841","authenticated-orcid":false,"given":"Woung-Ru","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"key20250910103930_B1","unstructured":"Edgar L, McLean S, Hogan S, Hamstra S, Holmboe E. The Milestones Guidebook. Accreditation Council for Graduate Medical Education (ACGME). 2020 https:\/\/www.acgme.org\/Portals\/0\/MilestonesGuidebook.pdf (accessed 26 December 2024)."},{"issue":"4","key":"key20250910103930_B2","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1634\/theoncologist.5-4-302","article-title":"SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer","volume":"5","year":"2000","journal-title":"Oncologist"},{"issue":"7","key":"key20250910103930_B3","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1002\/pon.4257","article-title":"Truth telling in Taiwanese cancer care: patients\u2019 and families\u2019 preferences and their experiences of doctors\u2019 practices","volume":"26","year":"2017","journal-title":"Psycho-Oncology"},{"issue":"2","key":"key20250910103930_B4","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1097\/SIH.0000000000000412","article-title":"Peer role-play for training communication skills in medical students: a systematic review","volume":"15","year":"2020","journal-title":"Simul Healthc"},{"issue":"6","key":"key20250910103930_B5","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1080\/01421590903002821","article-title":"The use of simulated patients in medical education: AMEE Guide No 42","volume":"31","year":"2009","journal-title":"Med Teach"},{"issue":"1","key":"key20250910103930_B6","first-page":"16","article-title":"Use of simulated patients for assessment of communication skills in undergraduate medical education in obstetrics and gynaecology","volume":"23","year":"2013","journal-title":"J Coll Physicians Surg Pak"},{"issue":"5","key":"key20250910103930_B7","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1017\/S147895151300031X","article-title":"Development and preliminary evaluation of communication skills training program for oncologists based on patient preferences for communicating bad news","volume":"12","year":"2014","journal-title":"Palliat Support Care"},{"issue":"20","key":"key20250910103930_B8","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1200\/JCO.2013.51.2756","article-title":"Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial","volume":"32","year":"2014","journal-title":"J Clin Oncol"},{"issue":"1","key":"key20250910103930_B9","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1186\/s12911-022-01952-0","article-title":"Challenges of telemedicine during the COVID-19 pandemic: a systematic review","volume":"22","year":"2022","journal-title":"BMC Med Inform Decis Mak"},{"key":"key20250910103930_B10","doi-asserted-by":"crossref","first-page":"103778","DOI":"10.1016\/j.compedu.2019.103778","article-title":"A systematic review of immersive virtual reality applications for higher education: Design elements, lessons learned, and research agenda","volume":"147","year":"2020","journal-title":"Comput Educ"},{"issue":"3","key":"key20250910103930_B11","doi-asserted-by":"crossref","first-page":"181","DOI":"10.7861\/fhj.2019-0036","article-title":"Virtual reality and the transformation of medical education","volume":"6","year":"2019","journal-title":"Future Healthc J"},{"issue":"9","key":"key20250910103930_B12","first-page":"446","article-title":"Comparative cost of virtual reality training and live exercises for training hospital workers for evacuation","volume":"37","year":"2019","journal-title":"Comput Inform Nurs"},{"issue":"2","key":"key20250910103930_B13","first-page":"100777","article-title":"The post COVID-19 pandemic era: Changes in teaching and learning methods for management educators","volume":"21","journal-title":"Int J Manag Educ"},{"issue":"Suppl 3(3)","key":"key20250910103930_B14","first-page":"S230","article-title":"Human-centered design lessons for implementation science: improving the implementation of a patient-centered care intervention","volume":"82","year":"2019","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"1","key":"key20250910103930_B15","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1038\/s41746-018-0034-4","article-title":"Training for our digital future: a human-centered design approach to graduate medical education for aspiring clinician-innovators","volume":"1","year":"2018","journal-title":"npj Digital Medicine"},{"issue":"2","key":"key20250910103930_B16","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/j.cegh.2019.12.010","article-title":"Virtual reality applications toward medical field","volume":"8","year":"2020","journal-title":"Clin Epidemiol Glob Health"},{"issue":"4","key":"key20250910103930_B17","article-title":"Nurse-physician communication team training in virtual reality versus live simulations: randomized controlled trial on team communication and teamwork attitudes","volume":"22","year":"2020","journal-title":"J Med Internet Res"},{"key":"key20250910103930_B18","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.nedt.2019.06.012","article-title":"Design and evaluation of a 3D virtual environment for collaborative learning in interprofessional team care delivery","volume":"81","year":"2019","journal-title":"Nurse Educ Today"},{"issue":"4","key":"key20250910103930_B19","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.acap.2017.01.010","article-title":"A virtual reality curriculum for pediatric residents decreases rates of influenza vaccine refusal","volume":"17","year":"2017","journal-title":"Acad Pediatr"},{"issue":"3","key":"key20250910103930_B20","doi-asserted-by":"crossref","first-page":"228","DOI":"10.4103\/efh.EfH_9_17","article-title":"Resident perspectives on communication training that utilizes immersive virtual reality","volume":"30","year":"2017","journal-title":"Educ Health (Abingdon)"},{"issue":"3","key":"key20250910103930_B21","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1002\/pon.3413","article-title":"Effectiveness of Japanese SHARE model in improving Taiwanese healthcare personnel\u2019s preference for cancer truth telling","volume":"23","year":"2014","journal-title":"Psycho-Oncology"},{"issue":"7","key":"key20250910103930_B22","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1002\/pon.3174","article-title":"Truth telling in medical practice: students\u2019 opinions versus their observations of attending physicians\u2019 clinical practice","volume":"22","year":"2013","journal-title":"Psycho-Oncology"},{"key":"key20250910103930_B23","volume-title":"Experience and education","year":"1938"},{"key":"key20250910103930_B24","volume-title":"Experiential learning: experience as the source of learning and development","year":"2015","edition":"2 ed"},{"issue":"3","key":"key20250910103930_B25","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.nedt.2013.06.009","article-title":"End of life care education, past and present: a review of the literature","volume":"34","year":"2014","journal-title":"Nurse Educ Today"},{"key":"key20250910103930_B26","volume-title":"Teaching and learning communication skills in medicine","year":"2005"},{"issue":"7","key":"key20250910103930_B27","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1002\/pon.1102","article-title":"Japanese cancer patients\u2019 communication style preferences when receiving bad news","volume":"16","year":"2007","journal-title":"Psycho-Oncology"},{"issue":"5","key":"key20250910103930_B28","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1002\/pon.5629","article-title":"Effectiveness of communication skill training on cancer truth-telling for advanced practice nurses in Taiwan: A pilot study","volume":"30","year":"2021","journal-title":"Psycho-Oncology"},{"key":"key20250910103930_B29","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.nedt.2017.09.006","article-title":"Evaluating best educational practices, student satisfaction, and self-confidence in simulation: a descriptive study","volume":"60","year":"2018","journal-title":"Nurse Educ Today"},{"issue":"5","key":"key20250910103930_B30","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.ecns.2015.03.003","article-title":"The Chinese student satisfaction and self-confidence scale is reliable and valid","volume":"11","year":"2015","journal-title":"Clin Simul Nurs"},{"key":"key20250910103930_B31","doi-asserted-by":"crossref","first-page":"2377960820930153","DOI":"10.1177\/2377960820930153","article-title":"Impact of standardized patients on first semester nursing students self-confidence, satisfaction, and communication in a simulated clinical case","volume":"6","year":"2020","journal-title":"SAGE Open Nurs"},{"issue":"6","key":"key20250910103930_B32","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1017\/S147895151500022X","article-title":"Enhancing student communication during end-of-life care: a pilot study","volume":"13","year":"2015","journal-title":"Palliat Support Care"},{"issue":"8","key":"key20250910103930_B33","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1177\/1049909114549954","article-title":"An interprofessional workshop for students to improve communication and collaboration skills in end-of-life care","volume":"32","year":"2015","journal-title":"Am J Hosp Palliat Care"},{"issue":"17","key":"key20250910103930_B34","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1080\/10447318.2020.1778351","article-title":"Virtual reality sickness: a review of causes and measurements","volume":"36","year":"2020","journal-title":"Int J Hum\u2013Comput Interact"},{"key":"key20250910103930_B35","doi-asserted-by":"crossref","first-page":"96","DOI":"10.3389\/fnhum.2020.00096","article-title":"Factors associated with virtual reality sickness in head-mounted displays: a systematic review and meta-analysis","volume":"14","year":"2020","journal-title":"Front Hum Neurosci"}],"container-title":["Perspectives on Medical Education"],"original-title":[],"link":[{"URL":"https:\/\/account.pmejournal.org\/index.php\/up-j-pme\/article\/download\/1684\/1965","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.pmejournal.org\/index.php\/up-j-pme\/article\/download\/1684\/1966","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.pmejournal.org\/index.php\/up-j-pme\/article\/download\/1684\/1967","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.pmejournal.org\/index.php\/up-j-pme\/article\/download\/1684\/1965","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T10:50:43Z","timestamp":1782816643000},"score":1,"resource":{"primary":{"URL":"https:\/\/account.pmejournal.org\/index.php\/up-j-pme\/article\/view\/1684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,10]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,9]]}},"URL":"https:\/\/doi.org\/10.5334\/pme.1684","relation":{},"ISSN":["2212-277X"],"issn-type":[{"value":"2212-277X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,10]]}}}