Virtual Reality for Invasive Procedural Training: Results from a Feasibility Study

Document Type

Conference Proceeding

Publication Date

11-1-2024

Publication Title

Anesth Analg

Abstract

Introduction: Current invasive procedural training for central venous access (CVA) relies on manikin-based simulator sessions. Given the evolution towards preclinical proficiency for skills acquisition, there is a pressing need for innovative training modalities to prepare the upcoming generation of physicians.[1] Virtual Reality (VR) is one potential technology that has been tested for training residents in certain specialties. [2,3] In this study our objective was to initiate the use of a novel VR technology for residents undergoing CVA training and assess its feasibility in comparison to the established manikinbased simulation training in our curriculum. Methods: This feasibility study was conducted from December 2022 to August 2023 in a single-center setting. We utilized the Vantari Virtual Reality Software (Sydney, Australia) on an Oculus Quest 2 VR Headset with Fast-Switch LCD Display and built-in 3D positional audio (Reality Labs; MetaPlatforms, Inc, Melo Park, CA). (FIGURE 1) We conducted a pilot of the VR technology among pre-internship medical graduates, medical interns, and PGY2s (CA1s), assessing their feedback compared with standard manikin-based simulation training with a survey distributed through Microsoft Forms (Microsoft, Redmond, WA). (FIGURE 2) Results: 17 volunteers including 5 medical graduates (PGY0), 5 interns (PGY1), and 7 first year anesthesia residents (PGY2) completed a training session on the VR simulator. (FIGURE 3) Seventy percent (n=3, strongly agree; n=9 agree) of participants found the VR equipment simple to operate and intuitive. 82.3% of participants (n=14) felt that the scenario mirrored real-life situations, with responses split between 'strongly agree' (3 participants) and 'agree' (11 participants). A significant majority, 70% (n=12), expressed confidence in their ability to use the VR training equipment independently, without the need for a supervising provider. While using the VR simulator, adverse effects were minimal. The reported adverse effects were nausea (5%), dizziness after extended use (5%), and headache after prolonged usage (5%). 76% (n=13) stated that they would like to use the simulator again. Of the 17 participants, 94% (n=16) agreed or strongly agreed that the VR simulator helps understand the different steps required for a proper central line placement. 65% (n=9) felt it developed awareness of proper ergonomics of equipment and ultrasounds (US). 41% (n=7) of participants agreed that the VR simulator helps the trainee to develop needle tracking skills. For comparison, traditional manikin training received slightly lower scores for understanding procedural steps (84.5% n=14), comparable rates for developing spatial awareness; (69.2% n=5), and higher rates for enhancing motor skills of proper utilization of instruments and US (70.5% n=6). Approximately 82% (n=14) of participants either agreed (n=11) or strongly agreed (n=3) that the VR scenario felt very realistic, simulating the environment of an OR. When participants were asked about their training preferences, 41% (n=7) showed a preference for the manikin, 18% (n=3) preferred VR, and 41% (n=7) viewed both as equally beneficial. Conclusions: Although manikin-based is the current standard method of training in our institution and many others, there are specific areas we have identified for potential enhancement. While it effectively enables the practice of US skills such as needle tracking and probe handling, it is often lacks a comprehensive, standardized, and structured portrayal of procedural steps. Moreover, it falls short in replicating a true-tolife environment crucial for a comprehensive simulation. VR on the other hand, provides an opportunity to simulate the milieu of the operating room, including ambient sounds, distractions, and the workspace. Beyond its capability to fully immerse a trainee in the simulation - the portability, cost-effectiveness, and accessibility render it a promising tool for invasive procedural training.[3] Our feasibility study suggests that while the current state of VR trainin models is inadequate when used independently, VR serves as a valuable supplement to standard manikin training. A larger multi-center observational study would be the next step to confirm our findings. The potential for future development in VR simulation, incorporating dynamic vital signs, patient anatomical variations, and common complications, could hold promise for significantly augmenting the efficacy of simulation training. (Figure Presented).

Volume

139

Issue

5

First Page

949

Last Page

951

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