SpineUniverse Highlight: PrecisionOS Virtual Reality Technology is Changing the Future of Surgical Training

SpineUniverse spoke with Danny P. Goel, MD, an orthopaedic surgeon, Chief Executive Officer and one of the Founders of PrecisionOS™; a company focused on bridging gaps in surgical training through its virtual immersive and lifelike simulation platform. Dr. Goel refers to the technology as “XR”—an expression that includes virtual reality (VR), mixed reality (MR) and augmented reality (AR).

Three hundred users train in a VR medical device sales meeting using a custom PrecisionOS module. Image courtesy of PrecisionOS Technology, Inc.

A Vision Built with Collective Talent

Dr. Goel’s initial idea was one of an accessible app to facilitate patient care and triage with musculoskeletal issues. That endeavor led him to meet Rob Oliveira and Colin O‘Connor, who had been in game development for 25 years each and wanted to transform their skillsets into something different—like healthcare.

Early discussions about virtual reality as a medical device or assistive tool helped identify shortfalls in patient care, including how surgeons acquire their knowledge-base and learn surgical procedures. Dr. Goel stressed the company’s success is not based on any one individual, but it’s a “team-centric collective effort” that created PrecisionOS’ interactive medical grade surgical training modules for healthcare providers today.

The Halstead Model

“We incorporate all the relevant principles of Halstedian theory,” said Dr. Goel who explained that training methods have been evolving for the last several hundred years as an apprenticeship-type model. The Halsted theory has been somewhat oversimplified referring to the famous “see one, do one and teach one.”

Halsted believed in experiential but mentorship-based learning. The foundation of his approach is a pillar of PrecisionOS. However, given the challenges of that model, surgeons typically practice on cadavers as a surrogate for the actual on-patient experience in the operating room. Cancelled because of COVID-19, the Global Spine Congress 2020 was to be the first training program without cadavers fully utilizing the PrecisionOS virtual reality platform to teach complex spine procedures.

Aside from several medical institutions in North America that partner with and use PrecisionOS’ educational platform for proficiency-based surgical training, Dr. Goel indicated they are also aligned with the AO Foundation as the preferred VR provider.

Image courtesy of PrecisionOS Technology, Inc.

Value-Added Virtual Learning

“There has been a lot of interest in virtual learning. The momentum for alternate models is consistent with the time and generation. The interest in VR was increasing prior to the global COVID-19 issues,” Dr. Goel said. “The pandemic has forced all of us to question the current model in many facets of life, and this is one of them,” he said.

When we consider the basic tenets of education, interleaving (practicing variability in skill), distributed learning (practicing a skill over time) and deliberate practice (experience obtained through immersive means with metrics and productive failure), a single experience violates all the above principles. Skills that are not reinforced can quickly decay over time. According to Ebbinghaus, lecture-based learning, a type of passive engagement, leads to 25% knowledge retention. "You will forget most of what you hear within about six days unless reinforced,” Dr. Goel said.

Further supplemental surgical training may include plastic models, reading, and videos—none of which are truly an immersive experience or one that recreates the nuances of the operating room. Surgeons who have been in practice for many years relate their experience has not come from doing the same procedures repeatedly (or partial task training), but from the variability in cases they have experienced during their careers. This becomes very apparent when you hear an expert discuss a case.

In addition to other quality research about immersive virtual reality surgical training, Dr. Goel pointed to an interesting randomized controlled trial recently published in The Journal Bone and Joint Surgery American. The study evaluated the effectiveness of immersive VR training in orthopaedic resident education by comparing a ‘VR resident group’ with a ‘traditional resident group.’ The results demonstrated the VR resident group grasped a complex surgical procedure 570% faster and outperformed the control group by 150%.1 A second randomized controlled trial was just completed and the results will be of significant interest to the medical community.

“PrecisionOS is challenging the whole educational approach on how we become proficient surgeons,” Dr. Goel stated. The PrecisionOS VR platform may provide physicians a solution to help achieve a level of experience currently not possible without years of exposure. It also allows one to keep pace with new operative techniques for safe integration into practice.

PrecisionOS’ unique platform places the physician into an environment identical to the operating room with the ability to manage surgical procedures while providing them with personalized analytics. Dr. Goel also commented, “It’s an exciting area and we are learning so much from this powerful technology. It continues to evolve in how we shape the future of surgical training.”

Updated on: 06/04/20
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