Immersive Virtual Reality Environment for Complex Cognitive Skills Curricular Training in Liver Surgery

Study Overview
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Brief Summary
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Investigators hypothesize that a virtual reality (VR) environment enhances general surgery residents' performance compared to Desktop Interface (DI)-based visualization of 3D models in decision making for patients with liver tumors. To determine this, a proficiency-based stepwise training curriculum for preoperative planning has been developed using both modalities. The overall objective of the curriculum is that by the end of the training program, residents would be able to formulate a treatment plan for patients with liver tumors.

Official Title
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Effectiveness of an Immersive Virtual Reality Environment on Curricular Training for Complex Cognitive Skills in Liver Surgery: A Multicentric Crossover Randomized Trial

Conditions
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Hepatobiliary Neoplasm

Intervention / Treatment
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* Behavioral: Clinical decision making based on visualizing liver 3D models in Virtual Reality (VR) environment or via a Desktop Interface (DI)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • General surgery residents irrespective of their postgraduate year Exclusion Criteria: No inform consent Residents of other specialties

Ages Eligible for Study
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Minimum Age: 18 Years

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: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Group A<br>Group A received first five patient cases and 3D models via DI and another five cases in the VR environment | Behavioral: Clinical decision making based on visualizing liver 3D models in Virtual Reality (VR) environment or via a Desktop Interface (DI)<br>* Visualizing 3D models of livers for preoperative surgical planning via two different environment: DI and VR in sequential order<br>|
| Other: Group B<br>Group B received first five patient cases and 3D models via VR and another five cases in the DI. | Behavioral: Clinical decision making based on visualizing liver 3D models in Virtual Reality (VR) environment or via a Desktop Interface (DI)<br>* Visualizing 3D models of livers for preoperative surgical planning via two different environment: DI and VR in sequential order<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Residents' decision-making accuracy | Residents' decision-making accuracy when reviewing patient data and 3D liver models using DI or VR, measured by comparing their performance to experts' opinions. The measurement tool will be a questionnaire consisting of ten questions, rate of correct answers will be recorded (e.g. 8/10 correct answers) and higher scores mean a better outcome. Minimum score=0; Maximum score=10. | Immediately after completing the educational intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognitive knowledge retention | Retention of knowledge assessed by validated multiple choice questions. Questionnaire consisted of 15 questions will be used, rate of correct answers will be recorded (e.g. 8/15 correct answers), and higher scores mean a better outcome. Minimum score=0; Maximum score=15. | Baseline and immediately after completing the educational intervention | 
| Residents' scores in recognizing intrahepatic structures and liver segments | Assessed by recognizing intrahepatic structures and 8 liver segments. Questionnaire consisted of 22 questions will be used, rate of correct answers will be recorded (e.g. 8/22 correct answers), and higher scores mean a better outcome. Minimum score=0; Maximum score=22. | Immediately after completing the educational intervention | 
| Time needed to devise a surgical plan using the DI or VR platform | Assessed by total time needed to make decision for 10 patient cases in minutes | Immediately after completing the educational intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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virtual reality, surgical education, 3D reconstruction, surgical planning, cognitive knowledge training, decision making