Training Using Immersive Virtual Reality

Study Overview
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Brief Summary
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In this study, the investigators examine the cognitive load (CL) and performance of a laparoscopic procedure in immersive virtual reality and controlled virtual reality in a randomized, controlled setup. Virtual reality (VR) simulators combined with head mounted displays (HMDs) enable highly immersive virtual reality (IVR) for surgical skills training, potentially bridging the gap between the simulation environment and real-life operating room (OR) conditions. However, the increased complexity of the learning situation in IVR could potentially induce high CL thereby inhibiting performance and learning.

Official Title
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Cognitive Load and Performance in Immersive Virtual Reality Versus Conventional Virtual Reality Simulation Training of Laparoscopic Surgery - a Randomized Trial

Conditions
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Cognitive Load, Performance

Intervention / Treatment
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* Other: Immersive virtual reality


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: First year resident Exclusion Criteria: Previous participation in trials involving laparoscopic training Prior experience with laparoscopic surgery (having performed one or more laparoscopic procedures as primary surgeon, including supervised procedures) Not speaking Danish on a conversational level
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: A single-center randomized trial was designed according to the CONSORT statement
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Immersive virtual reality<br>Completing the procedures in immersive virtual reality | Other: Immersive virtual reality<br>* In the IVR environment, four different 360-degrees videos were in sequence played as backdrop during the procedure. The videos reflected real life situations in the operating room with two videos representing calm periods, one video representing a light stressor and one video representing a severe stressor with a bleeding (2 ml/s) being triggered in the simulation. Participants complete the procedures while wearing the head mounted device.<br>|
| No Intervention: Conventional virtual reality<br>Completing the procedures in conventional virtual reality | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognitive load | Measurement of the participants cognitive load during four different time periods during the three procedures. Cognitive load was estimated by secondary-task reaction time. The investigators used an external and commercially available reaction timer (American Educational Products LLC, USA) to measure participants response time (in hundreds seconds) to an auditory stimulus (a beep). Reaction time was measured before and after the simulation to provide an individual baseline, and during the simulation at t=80 s, t=130 s, t=180 s and t=240 s. All reaction time measurements were done in series of four repeated measurements. It was also noted if the reaction time was measured while the participant was using the foot pedal for cauterization in the simulation. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to completion of procedure | Time to completion of procedure (measured in seconds) | 6 months | 
| Diathermy damage | Damage to surrounding tissue during the procedure (in number of incidents) | 6 months | 
| Blood loss | Blood loss during the procedure (in ml) | 6 months | 
| Efficience of instrument movements (length) | Measurement of movement of the left and right hand in meters | 6 months | 
| Efficience of instrument movements (degrees) | Measurement of angular movements of the left and right hand in degrees | 6 months |