Neurosurgery Resident University of Michigan Ann Arbor, Michigan, United States
Introduction: Lateral spine surgery has many benefits, but adoption has been limited by a steep learning curve. We previously showed that virtual reality (VR) improved resident education of lateral spine surgery in a single-institution pilot study of 5 residents. We sought to expand the study across institutions to further test this hypothesis.
Methods: Neurosurgery residents completed a VR-based lateral spine module 1x/week every other week for 6 weeks. Pre- and post-intervention surveys and intra-simulation performance metrics were assessed.
Results: 19 residents across 3 academical medical centers participated. 18 were neurosurgery and 1 was orthopedic surgery. 14 (74%) were PGY-3 and below. 6 (32%) are planning to subspecialize in spine. Three (16%) never performed a lateral prior to simulation, 14 (74%) had performed between 1-9 laterals, and 2 (11%) had performed 10+. Eleven (58%) had previously used VR, but only 1 (5%) had for spine education. Following simulation, residents showed an improvement in an automated simulation performance score (74% ± 9% vs 81% ± 10%, p <.05), intra-simulation x-rays used (51 ± 18 vs 41 ± 12, p = .053), and time to completion (29min ± 8min vs 16min ± 5 min, p <.01). From a scale of 1-10, residents reported improvement in comfort with anatomic landmarks for lateral access surgery (3.4 ± 1.5 vs 7.2 ± 1.9, p < .01), performing lateral surgery without direct supervision (1.4 ± 0.7 vs 5.6 ± 2.3, p < .01), and using fluoroscopy for hardware placement and image interpretation (5.1 ± 2.7 vs 7.8 ± 1.9, p < .01). Residents also reported an increase in the portion of a lateral case they feel comfortable performing without direction supervision (19.5% ± 21.0% vs 53.8% ± 24.1%, p<.01).
Conclusion : VR-based surgical simulation resulted in improved resident comfort with lateral surgery, simulation performance scores, and perceptions of VR as a curriculum supplement.
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