Virtual Reality in Medicine: Has Simulation found

a home

1Harrington CM, 1Kavanagh DO, 2Quinlan JE, 1Ryan D, 3Dicker P, 1Dunphy C, 1O’Keefe D, 1Traynor O, 1Tierney S.

1Dept. of Surgical Affairs, RCSI 2Dept. of Trauma & Orthopaedic Surgery, AMNCH

3Dept of Epidemiology & Public Health, RCSI

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Surgical Simulators

• Significantly underutilised*

1. Lack of simulator availability

2. Lack of Enjoyment/Interest Factor

3. Time commitments

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* Chang et al, Surg Endosc.

2007;21:418-21

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Accessible

Engaging Cost-Effective

Home

Environment

Trends in Virtual Reality

• VR predictions*

– Tens of Billions of revenue

– 2016 a Year of experimentation

– “Multiple applications for healthcare”

– Both PC and mobile compatible devices

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*Lee P. TMT Predictions 2016

report. Virtual reality (VR): a billion

dollar niche. Deloitte

Oculus Virtual Reality

• Fully Immersive

• ≈ €100 per headset

• Small & Portable

• Integrates with Smart-phone

• Hand representation pending

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RCSI Medical Simulator

• Moulage-Based

• Fully Interactive

• Decision-Making

• ATLS Trauma Guidelines

• Simulator Scores

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Evidence of Validation

• ATLS Course 2016

– 11 Instructors (84.6%) and 19 Candidates (86.4%)

– Standardised 360o video orientation followed by

Simulator trial

– Scores Correlated with expertise

– Electronic Feedback after completion

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Participant Demographics

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Survey Data Instructors

(n=10) Candidates

(n=16) Total

(n=26) Age 49.1 ± 9.9 32.5 ± 5.3 38.9 ± 11 Gender -Male -Female

9 (90) 1 (10)

12 (75) 4 (25)

21 (80.8) 5 (20.2)

Speciality -Orthopaedics & Trauma -Emergency Medicine -Anaesthesiology -General Surgery -Internship

4 (40) 4 (40) 1 (10) 1 (10)

-

4 (25) 7 (43.75)

- 4 (25)

1 (6.25)

8 (30.8)

11 (42.3) 1 (3.85) 5 (19.2) 1 (3.85)

Grade -Consultant -Specialist Registrar -Registrar -Senior House Officer -Intern

9 (90) 1 (10)

- - -

-

2 (12.5) 5 (31.25)

8 (50) 1 (6.25)

9 (34.6) 3 (11.5) 5 (19.2) 8 (30.8) 1 (3.85)

Experience with Virtual Reality HMD

1 (10) 2 (12.5) 3 (11.5)

Handedness -Right -Left

10 (100)

-

14 (87.5) 2 (12.5)

24 (92.3)

2 (7.7) *Mean ± SD, n (percent in parentheses)

Simulator Outcomes

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Analysis of simulator variables

Instructors (n=7)

Candidates (n=15) p-value*

No of Virtual-Patient Deaths Mean 0-1 Deaths 2 Deaths 3+ Deaths No of Correct Decisions No of Incorrect Decisions Percentage decisions-made that were incorrect No of Correct Diagnoses No of Incorrect Diagnoses Time (seconds)

0.86 ± 0.69 6 (85.7%) 1 (14.3%) 0 (0.0%)

21.86 ± 1.46

2.0 ± 1.53

8.27 ± 6.21

6.43 ± 0.78

1.14 ± 1.07

849.7 ± 11.3

2.87 ± 2.36 5 (33.3%) 3 (20.0%) 7 (46.7%)

20.87 ± 1.96

4.60 ± 3.25

17.18 ±10.09

6.13 ± 0.92

1.40 ± 1.18

857.7 ± 163.9

0.007

0.049

0.435

0.711

0.045

0.882

1.000

0.920

Mean ± SD, *Student’s t-test/Fisher’s exact test

VR Feedback

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Status Quo

100’000 + Downloads

381 + Days of usage

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VR Developments

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Conclusion

• Successful development of a VR concept medical training simulator.

• Evidence of Validation.

• High level of public utilisation.

• A foundation for future medical applications.

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Acknowledgements

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Acknowledgements

• Mr. Dara Kavanagh

• Mr. Donncha Ryan

• Prof. Oscar Traynor

• Prof. Sean Tierney

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• Mr. John Quinlan

• Mr. Patrick Dicker

• Ms. Dara O’Keeffe

• Mr. Conor Dunphy

Virtual Reality in Medicine: Has Simulation found

a home

1Harrington CM, 1Kavanagh DO, 2Quinlan JE, 1Ryan D, 3Dicker P, 1Dunphy C, 1O’Keefe D, 1Traynor O, 1Tierney S.

1Dept. of Surgical Affairs, RCSI 2Dept. of Trauma & Orthopaedic Surgery, AMNCH

3Dept of Epidemiology & Public Health, RCSI

NASCE Dublin 2016