Gomindes, Austin R, Adeeko, Elizabeth S., Khatri, Chetan, Ahmed, Imran, Sehdev, Simran, Carlos, William John, Ward, Thomas, Leverington, James, Debenham, Luke, Metcalfe, Andrew J. and Ward, Jayne (2023) Use of virtual reality in the education of orthopaedic procedures : a randomised control study in early validation of a novel virtual reality simulator. Cureus, 15 (9). e45943. doi:10.7759/cureus.45943 ISSN 2168-8184.
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Abstract
Background
Virtual reality (VR) simulation is a potential solution to the barriers surgical trainees are facing. There needs to be validation for its implementation within current training. We aimed to compare VR simulation to traditional methods in acquiring surgical skills for a TFN-ADVANCED™ Proximal Femoral Nailing System (TFNA; DePuy Synthes, Auckland, New Zealand) femoral nailing system.
Methods
Thirty-one surgical trainees were randomised to two groups: traditional-training group (control group) and a VR-training group (intervention group) for insertion of a short cephalomedullary TFNA nail. Both groups then inserted the same TFNA system into saw-bone femurs. Surveys evaluated validity of the relevant activities, perception of simulation, confidence, stress and anxiety. The primary outcomes were tip-apex distance (TAD) and user anxiety/confidence levels. Secondary outcomes included number of screw- and nail-guidewire insertion attempts, the time taken to complete and user validity of the VR system.
Results
There was no statistical difference in TAD between the intervention and control groups (9mm vs 15mm, p=0.0734). The only TAD at risk of cut-out was in the control group (25mm). There was no statistical difference in time taken (2547.5ss vs 2395ss, p=0.668), nail guide-wire attempts (two for both groups, p=0.355) and screw guide-wire attempts (one for both groups, p=0.702).
The control group versus intervention had higher anxiety levels (50% vs 33%) and had lower confidence (61% vs 84%).
Interpretation
There was no objective difference in performance on a saw-bone model between groups. However, this VR simulator resulted in more confidence and lower anxiety levels whilst performing a simulated TFNA. Whilst further studies with larger sample sizes and exploration of transfer validity to the operating theatre are required, this study does indicate potential benefits of VR within surgical training.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) R Medicine > RD Surgery |
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
| SWORD Depositor: | Library Publications Router |
| Library of Congress Subject Headings (LCSH): | Virtual reality in medicine, Medical education -- Methods, Surgery -- Study and teaching, Surgery -- Education, Educational technology -- Case studies, Orthopedics, Computer-assisted surgery, Computer simulation, Medicine -- Study and teaching (Higher) -- Simulation methods, Clinical medicine -- Computer-assisted instruction, Surgical robots |
| Journal or Publication Title: | Cureus |
| Publisher: | Springer |
| ISSN: | 2168-8184 |
| Official Date: | 25 September 2023 |
| Dates: | Date Event 25 September 2023 Published |
| Volume: | 15 |
| Number: | 9 |
| Article Number: | e45943 |
| DOI: | 10.7759/cureus.45943 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Open Access (Creative Commons open licence) |
| Date of first compliant deposit: | 10 November 2023 |
| Date of first compliant Open Access: | 10 November 2023 |
| URI: | https://wrap.warwick.ac.uk/180846/ |
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