Effectiveness of immersive virtual reality in surgical training - a randomized control trial

Introduction: The surgical training methods are evolving with technological advancements including the application of virtual reality (VR) and augmented reality (AR). Yet, twenty-eight to forty percent of novice residents are not confident in performing a major surgical procedure. VR Surgery, an immersive virtual reality (iVR) experience was developed using Oculus Rift and Leap Motion devices to address this challenge. It is a multi-sensory, holistic surgical training application, that demonstrates a maxillofacial surgical technique, Le Fort I osteotomy. Objective: The main objective of this study was to evaluate the impact of VR Surgery on the self-confidence and the knowledge of surgical residents. Design: A multisite, single-blinded, parallel, randomised controlled trial (RCT) was performed. The participants were novice surgical residents with a limited experience in performing the Le Fort I osteotomy. The primary outcome measures were the self- assessment scores of trainee’s confidence on a Likert scale and objective assessment of the cognitive skills. Ninety-five residents from seven dental schools took part in the RCT. The participants were randomly divided into a study group n=51, and a control group n=44. Participants in the study group used the VR Surgery application on an Oculus Rift with Leap Motion device. The control group participants used similar content in a standard PowerPoint presentation on a laptop. A repeated measures multivariate ANOVA was applied to the data to assess the overall impact of the intervention on the confidence of residents. Results: The study group participants showed a significantly higher perceived self-confidence levels compared to those in the control group (p=0.034, α=0.05). Novices in the first year of their training showed the highest improvement in their confidence, compared to those in the second and third year. Conclusion: iVR experiences improve the knowledge and self-confidence of the surgical residents