Assessing the efficacy of a virtual reality lower leg fasciotomy surgery training model compared to cadaveric training

Abstract

Background

Virtual reality (VR) holds great potential in education that has not been actualized in surgical training programs; much of the research into medical applications of VR have been in management and decision making rather than procedural training. This pilot study assessed the feasibility of virtual reality surgical educational training (VR-SET) in open trauma surgery procedures compared to in person cadaver-based training (CBT). In traditional surgical educational settings multiple trainees share a cadaver, often due to logistical and fiscal limitations precluding routine one-to-one trainee to cadaver ratios. Thus, some procedures are learned via observation of a fellow trainee performance on the cadaver rather than hands on performance. Cadaveric training opportunities are also less frequent for those practicing in low resource environments such as rural communities, smaller medical facilities and military combat zones.

Methods

Medical students (4th year, n = 10) who completed VR-SET training were compared to a control group (residents, n = 22) who completed an in-person Advanced Surgical Skills for Exposure in Trauma (ASSET) course. Participants were evaluated on performance of a lower extremity fasciotomy on a cadaver.

Results

VR-SET study participants decompressed an average of 2.45 ± 1.09 (range 1 to 4) compartments compared to the control group decompressed had an average of 2.06 ± 0.93 (range 0.5 to 4), statistically indistinguishable between the groups (p = 0.35). Numerical scores for anatomic knowledge, surgical management, and procedure performance were also not significantly different between groups. Control subjects had significantly higher pathophysiology knowledge and surgical technique scores.

Conclusions

Overall, VR-SET participants were indistinguishable from the in-person CBT cohort in number of compartments successfully decompressed. This pilot study suggests utilization of VR technologies in trauma educational settings may be effective and considered as a cost-effective solution for training to supplement cadaveric based courses.