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How virtual the truth is turning surgical training upside-down

The field of orthopedics is highly complicated and continually evolving, particularly because the fast and furious pace of new surgical devices and technologies accelerates.


The significance of impressive, accessible tools and resources, along with contact with hands-on surgical training, is crucial.

“Amid the digital acceleration of healthcare transformation, we are able to no longer depend on the age-old mantra, ‘See one, do one, teach one,’ to teach another generation of surgeons,” said Dr. Cory Calendine, chief of orthopedic surgery at Williamson INFIRMARY and orthopedic surgeon and founder of the Bone and Joint Institute of Tennessee.

“Rather, we have to implore them to ‘Do as much as possible,'” he continued. “Actually, the more practice a resident or attending surgeon can conduct, the more proficient they’ll become.”

With the aggressive pace of new devices, technologies and techniques, it becomes a lot more vital that you track and measure performance metrics. These shortfalls in proficiency come with real consequences for patients, surgeons and their healthcare institutions.

“Training shouldn’t stop for a surgeon, and we are in need of better methods,” Calendine said. “While fellowship programs remain a choice for additional training, numerous studies highlight a chance to create a better system of training.

“Further, recent changes by the ACGME, because of the COVID-19 pandemic, have imposed restricted scrub hours, severely limiting resident and fellow contact with patients, mentors and procedures,” he continued.

The correlation between surgical volume and performance to patient outcomes is undeniable. A recently available study by the University of Michigan discovered that 30% of surgeons cannot operate independently after residency.

“A 2019 study conducted by UCLA’s David Geffen School of Medicine discovered that the surgical performance using Osso VR’s platform improved surgical performance by 230%.”

Dr. Cory Calendine, Bone and Joint Institute of Tennessee

“Prevention of surgical errors requires the eye of most personnel mixed up in patient’s care, like the institutions tasked with creating a vibrant learning environment for resident education, training and research,” Calendine noted.


Calendine was introduced to vendor Osso’s virtual reality technology through its partnership with Stryker. He immediately was attracted to the technology.

“Beyond the cool factor, I really was taken aback with what a robust kind of training VR is,” he recalled. “Not merely may i teach residents the steps, however they can practice by themselves, as much times because they want without the risk to patients.

“Further, the platform can measure and score performance and proficiency at any degree of training, that is incredibly valuable since it allows myself along with other faculty members to objectively define how well we’re raising another generation of surgeons,” he continued.

Traditionally, surgical training, whether one is really a resident or fellow learning the ropes or are a skilled surgeon training on a fresh device, requires immense logistical planning and planing a trip to a one- or two-day workshop.

“For most surgeons, it could be 6 to 8 months before you have that one-time training to execute that procedure, device or technique on an individual,” Calendine explained. “Surgery is high stakes, and VR gets the extraordinary capability to deliver the most recent and greatest in surgical innovation to any seasoned or aspiring surgeon with a headset, all over the world.

“Headsets attended down tremendously in cost, if you calculate the airfare, hotel and shipment of devices or hardware, VR is really a cost-effective methods to give surgeons of most skill levels probably the most innovative, up-to-date training at scale,” he added.


Calendine has spent a lot more than eight years practicing and trained in robotics. And traditionally, that education was performed personally on categoric specimens. Through the years, he traveled around the globe, training a number of surgeons, from residents and fellows to attending and private practice, all on a cadaver from ground zero.

“Typical training scenarios involve a surgeon planing a trip to a one-to-two day training workshop,” Calendine explained. “In a few situations, surgeons are asked to perform a one- or two-day workshop for a fresh surgical device, and months later be likely to execute that procedure confidently.

“Offsite training isn’t only costly and time-consuming but lacks chance for the surgeon to keep to apply,” he added. “It may be six months prior to the surgeon actually utilizes that device throughout a procedure.”

Industry numbers estimate a surgeon must perform at the very least 75 cases to accomplish optimal proficiency, he said. Further complicating the problem is having less any objective assessment tool for surgical proficiency, so a surgeon and their team hardly ever really know if they are prepared, he added.

“With the proper VR platform, headset and controllers, residents can learn and practice specific procedures outside the operating room, even yet in the comfort of these own homes,” he noted. “These lifelike simulations could be reset and repeated without consequence, and dramatically improve procedural competence and confidence, directly translating to raised clinical outcomes and overall patient care.

“VR’s degree of genuineness gives users a really authentic experience that you see and feel immediately,” he continued. “It’s wildly impressive.”


Multiple studies show that VR isn’t just equitable to physical simulation, but additionally more advanced than traditional ways of medical education, Calendine said.

“A 2019 study conducted by UCLA’s David Geffen School of Medicine discovered that the surgical performance using Osso VR’s platform improved surgical performance by 230%,” he noted.

“Subsequent findings by researchers at the University of Illinois College of Medicine at Chicago which conducted a randomized, blinded validation study utilizing the Osso VR platform discovered that usage of virtual reality for surgical training significantly increased procedural accuracy and completion rate, which a lot more than tripled the chances of completing an operation successfully and demonstrated a 300% improvement in accuracy when residents been trained in the Osso VR module.”

This along with other studies demonstrate the undeniable advantage VR must significantly improve surgical performance and outcomes over the board, he added.


“My vision for VR is that people integrate it into all academic and private practice training programs,” Calendine stated. “Virtual reality will probably play a significant role in medical education continue, and I’d highly advise early integration of VR systems into resident and provider training programs.

“In the same way EHRs for better or worse have revolutionized the paper chart, virtual reality can be a very important, standardized and required tool in medical education and training,” he said. “From integrating VR into residency program curriculums to understand, repeat and practice surgical proficiency, to introducing new techniques and instruments during virtual conferences.”


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