Psychomotor skills development for Veress needle placement using a virtual reality and haptics-based simulator

Development and Usability Assessment of Virtual Reality- and Haptic Technology-Based Educational Content for Perioperative Nursing Education

BACKGROUND/OBJECTIVES

In perioperative nursing practice, nursing students can engage in direct, in-person clinical experiences in perioperative environments; however, they face limitations due to infection and contamination risks. This study aimed to develop and evaluate educational content for perioperative clinical practice for nursing students using virtual reality (VR) and haptic technology.

METHODS

The program, based on the Unity Engine, was created through programming and followed the system development lifecycle (SDLC) phases of analysis, design, implementation, and evaluation. This program allows nursing students to engage in perioperative practice using VR and haptic technology, overcoming previous environmental limitations and enhancing practical and immersive experiences through multi-sensory stimuli.

RESULTS

Expert evaluations indicated that the developed content was deemed suitable for educational use. Additionally, a usability assessment with 29 nursing students revealed high levels of presence, usability, and satisfaction among the participants.

CONCLUSIONS

This program can serve as a foundation for future research on VR-based perioperative nursing education.

Evaluation of a Virtual Reality-Based Open Educational Resource Software

OBJECTIVES

Virtual reality (VR) teaching methods have potential to support medical students acquire increasing amounts of knowledge. EVENT (Easy VR EducatioN Tool) is an open educational resource software for immersive VR environments, which is designed for use without programming skills. In this work, EVENT was used in a medical student VR course on pancreatic cancer.

METHODS

Medical students were invited to participate in the course. Before and after VR simulation, participants completed a multiple-choice knowledge assessment, with a maximum score of 10, and a VR experience questionnaire. The primary endpoint compared pre- and post-VR simulation test scores. Secondary endpoints included usability and factors that could affect learning growth and test results.

RESULTS

Data from 117 of the 135 participating students was available for analysis. Student test scores improved by an average of 3.4 points (95% CI 3.1-3.7, P < 0.001) after VR course. The secondary endpoints of gender, age, prior knowledge regarding the medical subject, professional training completed in the medical field, video game play, three-dimensional imagination skills, or cyber-sickness had no major impact on test scores or final ranking (top or bottom 25%). The 27 students whose post-VR simulation test scores ranked in the top 25% had no prior experience with VR. The average System Usability Scale score was 86.1, which corresponds to an excellent outcome for user-friendliness. Questionnaire responses post-VR simulation show students (81.2% [95/117]) interest in more VR options in medical school.

CONCLUSIONS

We present a freely available software that allows for the development of VR teaching lessons without programming skills.

Bimanual Intravenous Needle Insertion Simulation Using Nonhomogeneous Haptic Device Integrated into Mixed Reality

In this study, we developed a new haptic-mixed reality intravenous (HMR-IV) needle insertion simulation system, providing a bimanual haptic interface integrated into a mixed reality system with programmable variabilities considering real clinical environments. The system was designed for nursing students or healthcare professionals to practice IV needle insertion into a virtual arm with unlimited attempts under various changing insertion conditions (e.g., skin: color, texture, stiffness, friction; vein: size, shape, location depth, stiffness, friction). To achieve accurate hand-eye coordination under dynamic mixed reality scenarios, two different haptic devices (Dexmo and Geomagic Touch) and a standalone mixed reality system (HoloLens 2) were integrated and synchronized through multistep calibration for different coordinate systems (real world, virtual world, mixed reality world, haptic interface world, HoloLens camera). In addition, force-profile-based haptic rendering proposed in this study was able to successfully mimic the real tactile feeling of IV needle insertion. Further, a global hand-tracking method, combining two depth sensors (HoloLens and Leap Motion), was developed to accurately track a haptic glove and simulate grasping a virtual hand with force feedback. We conducted an evaluation study with 20 participants (9 experts and 11 novices) to measure the usability of the HMR-IV simulation system with user performance under various insertion conditions. The quantitative results from our own metric and qualitative results from the NASA Task Load Index demonstrate the usability of our system.

Veress needle insertion simulation model: A simple new module for advanced surgical skill training

Introduction

Training on Veress needle (VN) insertion cannot be done by observation without practicing tactile feedback. In this study, a simple and reproducible VN insertion training model was created. The aim of this study was to evaluate the validity of using the proposed model in simulating actual real-life surgical experiences.

Methods

The proposed VN insertion training model is made of three layers of synthetic rubber and plastic materials, simulating the tensile strength and texture of the three abdominal wall muscle layers. Surgeons and senior residents with experience in minimally invasive procedures were asked to practice VN insertion on this model, each completing the procedure three times. Participants were then asked to record their comments and answer six questions regarding their experience practicing on the model.

Results

Ten surgeons and four senior residents participated in this study. All participants agreed or strongly agreed that the model simulates the surgery experience regarding the shape and overall structure, tactile feedback and confirmation of complete/successful insertion. Twelve participants (86%) agreed or strongly agreed that the pressure/force needed for VN insertion was like real surgery experience and that the overall experience with using this model is similar to the real surgical experience. Almost all participants (93%) agreed or strongly agreed that the model is a valuable resource for training before practicing the procedure on real patients.

Conclusions

The VN insertion training model provides a valuable training opportunity on a demanding surgical skill. It is simple, reproducible and closely simulates surgery.

Virtual Reality and Three-Dimensional Printed Models Improve the Morphological Understanding in Learning Mandibular Sagittal Split Ramus Osteotomy: A Randomized Controlled Study

Background: The mandibular sagittal split ramus osteotomy (SSRO) is a routine operation performed to correct mandibular deformity including mandibular retrusion, protrusion, deficiency, and asymmetry. The SSRO remains a challenging procedure for junior surgeons due to a lack of adequate morphological knowledge necessary for success in clinical practice. Virtual reality (VR) and three-dimensional printed (3DP) models have been widely applied in anatomy education. The present randomized, controlled study was performed to evaluate the effect of traditional educational instruments, VR models, and 3DP models on junior surgeons learning the morphological information required to perform SSRO.

Methods: Eighty-one participants were randomly assigned to three learning groups: Control, VR, and 3DP. Objective and subjective tests were used to evaluate the learning effectiveness of each learning instrument. In the objective test, participants were asked to identify 10 anatomical landmarks on normal and deformed models, draw the osteotomy line, and determine the description of SSRO. In the subjective test, participants were asked to provide feedback regarding their subjective feelings about the learning instrument used in their group.

Results: The objective test results showed that the VR and 3DP groups achieved better accuracy in drawing the osteotomy line (p = 0.027) and determining the description of SSRO (p = 0.023) than the Control group. However, there was no significant difference among the three groups regarding the identification of anatomical landmarks. The VR and 3DP groups gave satisfactory subjective feedback about the usefulness in learning, good presentation, and enjoyment. The Control and 3DP groups reported positive feelings about ease of use.

Conclusion: The current findings suggest that VR and 3DP models were effective instruments that assisted in the morphological understanding of SSRO-related anatomical structures. Furthermore, 3DP models may be a promising supplementary instrument to bridge the gap between conventional learning and clinical practice.

Novel do-it-yourself low-cost abdominal laparoscopy entry simulator for gynaecology trainees

The COVID-19 pandemic has affected gynaecology trainees in the United Kingdom by reducing operating theatre experience. Simulators are widely used for operative laparoscopy but not for practising laparoscopic-entry techniques. We devised a low-cost simulator to help trainees achieve the skill. Our aim was to pilot this low-cost simulator to perform Royal College of Obstetricians and Gynaecologists (RCOG) supervised learning events.

A single-centre pilot study involving six gynaecology trainees in a structured training session. Interactive PowerPoint teaching was followed by trainees’ demonstration of laparoscopic entry for a supervised learning event and personalized feedback. Participants completed pre- and post-course questionnaires.

All the trainees found the training useful to the score of 10 (scale of 1–10) and recommended this to be included in Deanery teaching. Personalized feedback was described as the most useful. The simulator was rated as good as a real-life patient relative to the skill being taught.

Gynaecology trainees are affected by lack of hands-on experience in the operating theatre for performing laparoscopic entry. A low-cost abdominal laparoscopy entry simulator can help deliver the RCOG curriculum, enabling trainees to achieve required competencies.