American Council of Academic Plastic Surgeons
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Description and Early Validation of the Use of a Immersive Virtual Reality Learning Module in Deliberate Practice of Zygoma Fractures Among Surgical Residents
Oday Obaid, MD; Julia Corcoran, MD; Daniel Won
University of Illinois at Chicago

Background: Operative management of facial fractures is a three-dimensional (3D) educational challenge faced by surgery residents. Currently, most knowledge-based learning occurs outside the operating room (OR) using textbooks and videos with occasional use of cadaver and 3D models. We hypothesized that use of immersive virtual reality (IVR) could offer a realistic, reproducible, and feasible, 3D learning environment to fill in the gap between conventional learning modalities and experiential learning in the OR. Secondarily, we hypothesized that the gamified experience would improve residents’ learning.
Methods: An IVR module was programmed from a CT scan of human skeleton with an isolated zygomaticomaxillary complex (ZMC) fracture. Twenty participants completed a pre-intervention questionnaire assessing their demographics and gaming/surgical backgrounds. After watching a platform demonstration and completing a trial game, participants were asked to complete the module by identifying, segmenting, reducing, and plating the ZMC fracture using IVR. Participants then completed a post-intervention questionnaire to assess their experience with the IVR environment and its effectiveness for surgical learning and planning.
Results: The module was considered useful for conceptualization of operative anatomy (mean 4.3±1 out of 5; 5 being strongly agree), being an effective learning tool (mean 4.1±0.9), and its potential use in other training areas (mean 4.2±1). Senior residents indicated particular support for IVR’s benefit in improving operative competence and confidence (mean 3.6, p=0.02), and supported using IVR to replace other surgical training modalities (mean 3.6±0.7; p=0.03). The module was described as effective for surgical planning (mean 4.2±0.8). The anatomy and 3D perception of the module were found to be realistic (means 4.4±0.6 and 4.4±0.9, respectively)
Conclusion: The use of IVR in surgical training shows promising potential to fill the gap between knowledge-based and experiential learning of facial fractures. IVR provides a reproducible, digitally modifiable, and feasible modality, which utilizes patient-specific anatomy for pre-operative rehearsal and deliberate practice. The gamified experience associated with IVR may play a role in motivating residents and improving learning dynamics. More studies focusing on content validity and measuring objective performance metrics will help establish IVR validity as an innovative surgical training strategy.

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