Virtual Reality as a Tool for Surgical and Anesthesia Training

Medical education continues to develop year after year, and anesthesiology continues to do so as well. In the conventional pathway of training to become a physician, future anesthesiologists are required to pass two years of a traditional pre-clinical academic program, in addition to two years of clerkships, and then complete a residency and possibly an advanced fellowship. Requisite clinical skills are taught under the direction of a senior physician in the operating room (OR), and students learn more as their clinical responsibilities increased.

There is now discussion in the literature on the advantages of preparation prior to an anesthesia trainee entering the OR. This concept has begun to take hold at the medical school level. To use an example, many medical schools in the United States have now introduced technology to teach anatomy. Virtual reality simulations provide an arena for students to practice simulated dissections to learn anatomy before they enter the actual laboratory course. These technologies continue to improve yearly and have positive reviews from medical students. In light of such successes, virtual reality is now more frequently used as a tool for learning throughout training, including anesthesia residency.

A recent study from the University of Toronto explored the efficacy of virtual reality education compared to conventional clinical education with regards to developing fiber optic intubation skills. Anesthesia residents were separated randomly into a control group, which learned and practiced intubation on a standard medical training mannequin, and the exploratory group, which learned the same skills using a virtual reality program. The virtual reality program was created by an external manufacturer and was specific for anesthesiologists. After receiving training, anesthesia residents from both groups were then tasked with performing intubations on real patients, and scored by an independent rater. Scores were recorded with respect to time, a global rating scale, and a checklist of numerical verification. The raters were blinded to the order and group designation of all residents. After analyzing the data, the researchers discovered that residents who learned using virtual reality reached their optimal performance at a faster pace that is after less practice intubations, compared to the control group. Moreover, the global rating scales were higher, and time to completion faster, in the virtual reality group. Given these results, the research team has advised that teaching hospitals consider adding virtual reality into their anesthesiology residency curricula if possible. Additionally, it is recommended that further studies will investigate the long-term retention of skills learned using virtual reality, along with increasing the variety of procedures taught using virtual reality.

Alongside the tactical and surgical skills required of an anesthesiologist, patient care performance is also important. Virtual reality is in parallel entering the anesthesia training process, as evidenced by recent developments, including an emphasis on managing post-operative pain. A flagship research program from Stanford University has explored the quality and success of a virtual reality application that allows clinicians to engage with patients, in real-time, in order to minimize pain and increase satisfaction. Using this application, physicians were able to analyze the ways in which certain actions can alter the relationship between patient and provider. Moreover, this technology has been used by anesthesiologists and other anesthesia providers to explore how anxiety affects pain, which is related to post-operative outcomes and the patient experience. When used intelligently, the program was found to be connected to decreased patient anxiety, in line with decreasing the patient’s perception of pain.

Further research will continue to study the advantages of virtual reality as a tool for training, education, and skills acquisition in anesthesia. Anesthesiologists, by using technology as a learning tool, can position themselves as leaders in expanding and improving patient care.

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