How virtual reality can simulate new facets of surgery without wasting resources or risking patient safety
A 2014 study highlighted the medical simulation market’s significant growth and projected its value to rise to around $2 billion by 2019. As this technology improves, training methods fueled by its advancements continue to grow along with it. At the same time, the medical profession has shifted its emphasis to evidence-based treatment and training, in an effort to objectively measure the effectiveness of both treatment and training activities.
An increased focus on education and training innovation leads to better patient outcomes, fewer medical errors and improved team management skills. The global market is currently buzzing with medical simulation growth, and virtual reality (VR) is introducing new possibilities that have been in the visioning stage for years. VR is beginning to influence the trajectory and goals of future simulators.
How VR is Improving Medical Training
Technology as a whole is changing the healthcare field, providing different methods for treatment, procedures, practice guidelines and record keeping, aimed at improving patient outcomes and system efficiency.
In medical training we say that “perfect practice makes perfect.” However, some procedures are nearly impossible to fully practice until they must actually be performed. While surgeons can learn from mannequins, cadavers or videos, nothing can compare to the tense, physical scenario of performing a real-time procedure in an operating room. Enter VR to supplement the current delivery of simulation-based training, which can simulate new facets of surgery without wasting resources or risking patient safety.
VR has its roots in university research, entertainment gaming, and military training, going back as far as the 1980’s. Recently, this triad has been joined by some very aggressive start-up companies like Magic Leap and The Void, as well as established leaders like Microsoft and Facebook. This is an indication that the technology has reached a state where it can effectively and profitably be applied to a number of industries that have been interested in it for decades. These companies are also extending traditional VR, or full immersion, to Augmented Reality (AR), or mixed immersion. Magic Leap and Microsoft systems both seek to overlay virtual assets onto a view of the real world, opening the door to an entirely new set of commercial applications.
Similar to the precision and consideration needed to conduct a plan in the military, surgical procedures demand a training regimen designed with as much attention to detail. Take robotic surgery, for example. With the introduction of the da Vinci surgical system, surgeons can operate on patients with their head in the console and robotic hands on the patient. This technology required a tremendous amount of training for surgeons to reduce patient error and maintain communication with the team. According to some thought leaders, it takes 200 procedures for a surgeon to be considered proficient with a robotic surgery system, and it would not be time- or cost-efficient for a surgeon to perform these procedures on an actual da Vinci system, which reinforces the need for simulation.
Medical simulators, such as the Mimic dV-Trainer and the Simbionix RobotiX Mentor, were created for this reason, giving surgeons a chance to feel what it’s like to actually perform surgery in a comprehensive and realistic technological platform. These devices have focused on the use of robotic instruments inside the patient, but VR can also help surgeons with team training in the OR during a robotic procedure. With a surgeon’s head in the console, communicating with the team may be more difficult than a traditional procedure, but it’s just as important for patient safety. VR headsets may extend the reach of the simulator so that the surgeon can be more mobile and flexible. These games can provide surgeons a tense scenario where they can practice their emergency protocol with their virtual team, not only learning the technical logistics of robotic surgery, but also the methods for effective communication.
What VR Means for the Global Market
In most fields, including medicine, it is generally not popular to state that government and professional regulation can lead to better delivery of services or treatment for customers. But, when it comes to training, a requirement that courses provide objective metrics of student performance can make a significant impact on patient safety.
The American College of Surgeons and similar organizations have been emphasizing the need for performance-based progression through educational experiences, meaning that simply attending and participating in an educational event is no longer sufficient to become privileged to use a device or perform a procedure. Instead, students must demonstrate measurable skill levels in order to be cleared to use those skills on human patients.
Objectively measuring skills is extremely difficult for a human instructor leading and observing a multi-person class. Neither are written exams a good tool to measure skills. Simulations present a performance environment that can be measured objectively for every student on every iteration. These devices would seem to be an essential part of the movement to base medical practice on objective metrics of competency and training effectiveness.
Adding VR and AR to these simulators extends the reach of the computer-generated and computer-measured simulation environments. This in turn creates a wider range of skills which can be verifiably measured against standards set by expert performers.
Where societies and regulators insist on objective measurement of skills, there will emerge a significant demand for simulator devices that can deliver this. It should also lead to a reduction in surgical errors and an improvement in patient outcomes, though scientific evidence of this must be collected to ensure expectations live up to reality. However, absent such regulation, it is difficult to generate the momentum to invest in additional simulation, improved metrics and objective passing thresholds.
The immersive quality of VR may allow physicians to learn to make critical decisions for their patients in a technologically-rich environment. Improvements in the technology and the expectation of demonstrable skill levels from practitioners should stimulate the medical simulation market to grow and increase its value with each passing year. As the technology advances and social expectations for proficiency escalate, so will the demand for education and training programs on how to use the medical simulation devices and how to integrate them into a hospital system. We are at the very tip of the iceberg of this exciting trend, and current and future surgeons should look forward to VR’s significant impact on medical training and the practice of medicine.