Trend to Watch: Virtual Reality Training Takes Off

Virtual reality (VR) combines immersive, scalable technology with engaging and affordable education platforms to provide what many experts believe will become a standard training tool for healthcare providers. In fact, plenty of surgical professionals are already tapping into the benefits of learning through VR.

UConn Health’s Musculoskeletal Institute in Farmington, Conn., one of the nation’s top research facilities, opted to incorporate VR training into its orthopedic residency program at a very fortuitous time — right before COVID-19 temporarily shut down elective procedures. “Like everyone, we were challenged in trying to train surgeons without surgery,” says Lauren E. Geaney, MD, an assistant professor of orthopedic surgery and program director at UConn Health. “It was a really good opportunity for us to play with the technology and figure out how it would fit with our standard curriculum.”

The VR platform UConn uses places residents in realistic OR environments and allows them to practice their hand-eye coordination and visual spatial awareness in a variety of surgeries. “They can identify parts of procedures they struggle with and work through them until their performance improves,” says Dr. Geaney.

For instance, VR allows residents to break down each segment of a hip fracture repair — determining where to stabilize bones, figuring out where nails and screws should go — so they can focus the bulk of their training where it would benefit them most. Dr. Geaney and her residents call this strategic repetition of targeted training “purposeful practice.”

The personalized approach to surgical training afforded by VR cannot be overstated because everyone learns at different speeds, and sometimes the only thing holding residents back from developing the skills they need to be top surgeons is a lack of practice and repetition. VR can provide that — without many of the obstacles inherent in traditional training programs.

UConn’s residents share the four VR headsets the health systems purchased and can immerse themselves in procedures of their choice when it’s convenient for them. Dr. Geaney says UConn shares the training software with residents who have VR headsets at home so they can practice surgery on their own time. “The more access you can give them, the better their training will be,” she says.

Another benefit of VR is the vantage point it affords educators like Dr. Geaney, who says the technology makes it much easier to identify what residents are doing right and, more importantly, what they’re doing wrong. During an actual surgery, Dr. Geaney watches a resident’s actions and techniques, but out of habit she also notices what’s going on elsewhere in the OR.

“I’m seeing what residents are doing, but my gaze might shift to the display of the patient’s X-ray because that’s how I’m used to performing surgery,” says Dr. Geaney. “With VR, I can log into the program as residents are using it, so I’m watching in real-time what they’re seeing and doing. That allows me to pick up on subtleties I might not have seen otherwise.”

For instance, residents will often fixate on their hands when they’re scoping during arthroscopy procedures when they should be focusing on the image displayed on the video monitor. Dr. Geaney says VR allows her to notice these opportunities to improve surgical techniques that might not be caught during conventional surgery.

One of the most difficult aspects of teaching and training residents is determining when they’re truly competent and ready to operate on their own, and creating an appropriate plan to address their weaknesses. “This is something we all struggle with as educators,” says Dr. Geaney. “How do you recognize a resident who’s deficient and remediate their flaws in technique? The best approach isn’t always clear cut.”

VR training can help educators with this challenge based on the feedback the programs provide in terms of alerting residents to instances where their hand-eye coordination could have been better or where they missed their intended mark with an instrument. “The technology helps us create an individualized improvement plan that focuses on developing specific skills and techniques,” says Dr. Geaney.