TY - JOUR

T1 - Preparing for Reality

T2 - A Randomized Trial on Immersive Virtual Reality for Bronchoscopy Training

AU - Andersen, Annarita Ghosh

AU - Rahmoui, Laila

AU - Dalsgaard, Tor Salve

AU - Svendsen, Morten Bo Søndergaard

AU - Clementsen, Paul Frost

AU - Konge, Lars

AU - Bjerrum, Flemming

N1 - Publisher Copyright: © 2023 S. Karger AG, Basel.

PY - 2023

Y1 - 2023

N2 - Background: Bronchoscopy is an essential procedure in the diagnosis and treatment of pulmonary diseases. However, the literature suggests that distractions affect the quality of bronchoscopy and affect inexperienced doctors more than experienced. Objectives: The objective of the study was as follows: does simulation-based bronchoscopy training with immersive virtual reality (iVR) improve the doctors' ability to handle distractions and thereby increase the quality, measured in procedure time, structured progression score, diagnostic completeness (%), and hand motor movements of a diagnostic bronchoscopy in a simulated scenario. Exploratory outcomes were heart rate variability and a cognitive load questionnaire (Surg-TLX). Methods: Participants were randomized. The intervention group practiced in an iVR environment with a head-mounted display (HMD) while using the bronchoscopy simulator, while the control group trained without the HMD. Both groups were tested in the iVR environment using a scenario with distractions. Results: 34 participants completed the trial. The intervention group scored significantly higher in diagnostic completeness (100 i.q.r. 100-100 vs. 94 i.q.r. 89-100, p value = 0.03) and structured progress (16 i.q.r. 15-18 vs. 12 i.q.r. 11-15, p value 0.03) but not in procedure time (367 s standard deviation [SD] 149 vs. 445 s SD 219, p value = 0.06) or hand motor movements (-1.02 i.q.r. -1.03-[-1.02] versus -0.98 i.q.r. -1.02-[-0.98], p value = 0.27). The control group had a tendency toward a lower heart rate variability (5.76 i.q.r. 3.77-9.06 vs. 4.12 i.q.r. 2.68-6.27, p = 0.25). There was no significant difference in total Surg-TLX points between the two groups. Conclusion: iVR simulation training increases the quality of diagnostic bronchoscopy in a simulated scenario with distractions compared with conventional simulation-based training.

AB - Background: Bronchoscopy is an essential procedure in the diagnosis and treatment of pulmonary diseases. However, the literature suggests that distractions affect the quality of bronchoscopy and affect inexperienced doctors more than experienced. Objectives: The objective of the study was as follows: does simulation-based bronchoscopy training with immersive virtual reality (iVR) improve the doctors' ability to handle distractions and thereby increase the quality, measured in procedure time, structured progression score, diagnostic completeness (%), and hand motor movements of a diagnostic bronchoscopy in a simulated scenario. Exploratory outcomes were heart rate variability and a cognitive load questionnaire (Surg-TLX). Methods: Participants were randomized. The intervention group practiced in an iVR environment with a head-mounted display (HMD) while using the bronchoscopy simulator, while the control group trained without the HMD. Both groups were tested in the iVR environment using a scenario with distractions. Results: 34 participants completed the trial. The intervention group scored significantly higher in diagnostic completeness (100 i.q.r. 100-100 vs. 94 i.q.r. 89-100, p value = 0.03) and structured progress (16 i.q.r. 15-18 vs. 12 i.q.r. 11-15, p value 0.03) but not in procedure time (367 s standard deviation [SD] 149 vs. 445 s SD 219, p value = 0.06) or hand motor movements (-1.02 i.q.r. -1.03-[-1.02] versus -0.98 i.q.r. -1.02-[-0.98], p value = 0.27). The control group had a tendency toward a lower heart rate variability (5.76 i.q.r. 3.77-9.06 vs. 4.12 i.q.r. 2.68-6.27, p = 0.25). There was no significant difference in total Surg-TLX points between the two groups. Conclusion: iVR simulation training increases the quality of diagnostic bronchoscopy in a simulated scenario with distractions compared with conventional simulation-based training.

KW - Cognitive load

KW - Flexible bronchoscopy

KW - Head-mounted device

KW - Immersive virtual reality

KW - Simulation

U2 - 10.1159/000528319

DO - 10.1159/000528319

M3 - Journal article

C2 - 36796339

AN - SCOPUS:85149297743

VL - 102

SP - 316

EP - 323

JO - Respiration

JF - Respiration

SN - 0025-7931

IS - 4

ER -