Virtual reality technology for surgical learning: qualitative outcomes of the first virtual reality training course for emergency and essential surgery delivered by a UK-Uganda partnership.

INTRODUCTION: The extensive resources needed to train surgeons and maintain skill levels in low-income and middle-income countries (LMICs) are limited and confined to urban settings. Surgical education of remote/rural doctors is, therefore, paramount. Virtual reality (VR) has the potential to disseminate surgical knowledge and skill development at low costs. This study presents the outcomes of the first VR-enhanced surgical training course, 'Global Virtual Reality in Medicine and Surgery', developed through UK-Ugandan collaborations. METHODS: A mixed-method approach (survey and semistructured interviews) evaluated the clinical impact and barriers of VR-enhanced training. Course content focused on essential skills relevant to Uganda (general surgery, obstetrics, trauma); delivered through: (1) hands-on cadaveric training in Brighton (scholarships for LMIC doctors) filmed in 360°; (2) virtual training in Kampala (live-stream via low-cost headsets combined with smartphones) and (3) remote virtual training (live-stream via smartphone/laptop/headset). RESULTS: High numbers of scholarship applicants (n=130); registrants (Kampala n=80; remote n=1680); and attendees (Kampala n=79; remote n=556, 25 countries), demonstrates widespread appetite for VR-enhanced surgical education. Qualitative analysis identified three key themes: clinical education and skill development limitations in East Africa; the potential of VR to address some of these via 360° visualisation enabling a 'knowing as seeing' mechanism; unresolved challenges regarding accessibility and acceptability. CONCLUSION: Outcomes from our first global VR-enhanced essential surgical training course demonstrating dissemination of surgical skills resources in an LMIC context where such opportunities are scarce. The benefits identified included environmental improvements, cross-cultural knowledge sharing, scalability and connectivity. Our process of programme design demonstrates that collaboration across high-income and LMICs is vital to provide locally relevant training. Our data add to growing evidence of extended reality technologies transforming surgery, although several barriers remain. We have successfully demonstrated that VR can be used to upscale postgraduate surgical education, affirming its potential in healthcare capacity building throughout Africa, Europe and beyond.

Virtual Reality for Anatomy and Surgical Teaching.

The COVID-19 pandemic has led to significant challenges when it comes to the delivery of education across multiple domains. There has been a shift in paradigm towards the use of new innovative methods for the delivery of training within medicine and surgery. In this chapter, there is an outline of one such innovative method, the use of virtual reality for anatomy and surgical teaching. At all levels of training, undergraduate through to postgraduate specialty-based training, conventional methods of learning anatomy have had to be adapted due to difficulties encountered during the pandemic. The importance of hands-on cadaveric anatomy experience in surgical training cannot be understated. The decline in face-to-face sessions, as well as a reduction in bedside training due to the prioritisation of service provision and diminishing time spent in theatre have meant less exposure for trainees when it comes to learning procedural skills. Virtual Reality in Medicine and Surgery, a free for trainee resource utilising virtual reality technology, delivered 51-week courses with the aim to ensure high-quality training still occurred. The authors believe there is immense potential for immersive technology when it comes to the future of training within medicine and surgery.

Expanding our concept of simulation in radiology: a "Radiology Requesting" session for undergraduate medical students.

Objectives: Whilst radiology is central to the modern practice of medicine, graduating doctors often feel unprepared for radiology in practice. Traditional radiological education focuses on image interpretation. Key areas which are undertaught include communication skills relating to the radiology department. We sought to design teaching to fill this important gap. Methods: We developed a small group session using in situ simulation to enable final and penultimate year medical students to develop radiology-related communication and reasoning skills. Students were given realistic cases, and then challenged to gather further information and decide on appropriate radiology before having the opportunity to call a consultant radiologist on a hospital phone and simulate requesting the appropriate imaging with high fidelity. We evaluated the impact of the teaching through before-and-after Likert scales asking students about their confidence with various aspects of requesting imaging, and qualitatively through open-ended short answer questionnaires. Results: The session was delivered to 99 students over 24 sessions. Self-reported confidence in discussing imaging increased from an average of 1.7/5 to 3.4/5 as a result of the teaching (p < 0.001) and students perceived that they had developed key skills in identifying and communicating relevant information. Conclusions: The success of this innovative session suggests that it could form a key part of future undergraduate radiology education, and that the method could be applied in other areas to broaden the application of simulation. Advances in knowledge: This study highlights a gap in undergraduate medical education. It describes and demonstrates the effectiveness of an intervention to fill this gap.