The aVOR App Increases Medical Students’ Competence in Treating Benign Paroxysmal Positional Vertigo (BPPV)

HYPOTHESIS: Implementation of the "aVOR app" into teaching courses at medical school enhances students' satisfaction with the course and increases their competence in treating benign paroxysmal positional vertigo (BPPV). BACKGROUND: BPPV is often underdiagnosed and left untreated. One problem in teaching the management of BPPV to health care professionals is the lack of simulation-based training tools. The aVOR app (aVOR = angular vestibulo-ocular reflex) works as a bionic labyrinth that simulates the activation of the semicircular canals by rotational acceleration and the resulting vestibular evoked eye movements. METHODS: In this prospective, randomized, controlled study, medical students at a university hospital were randomly assigned to two kinds of small instructional groups. Students of the control group (n = 67) practiced diagnostic and therapeutic maneuvers for BPPV on each other, while the participants of the study group (n = 46) used the aVOR app as a virtual patient in addition. At the end of the term, students were asked to arrange the steps of the canalith repositioning procedure in the correct order in a written test. RESULTS: Quality of the teaching media was rated significantly better in the aVOR group (two-sided Mann-Whitney test: P < 0.00001). Significantly more students of the aVOR group than the control group arranged the steps of the canalith repositioning procedure correctly in the final exam (56.3% versus 25.9%, Fisher's exact test: P = 0.006). CONCLUSION: Implementation of the aVOR app as a virtual patient into small instructional courses is well adopted by medical students and increases their competence in treating BPPV.