Impact of haptic feedback on surgical training: A Randomized Controlled Trial of haptic versus non-haptic immersive virtual reality training.

The Annals of Medicine and Surgery has published the results of a trial, testing the promises of haptics-integrated VR surgical simulations. Conducted by Drs Gani, Pickering, Sabri, and Pucher, the trial aimed to evaluate the educational impact of integrated haptic feedback in an immersive VR bone drilling simulation on the real-world benchtop performance of a cohort of surgeons in a double-blind randomized controlled trial. The trial demonstrated a significant improvement in trainees’ learning curve and significantly better surgical outcomes, supporting the role of haptic integration in VR simulation models.

Junior trainees (foundation year and core surgical trainees, representing non-specialized levels of training) were recruited across three London-area hospitals. A double-blind randomized control trial involving 31 participants was performed, using training modules provided by FundamentalVR. Participants were randomly allocated to either a (1) Haptic or (2) Non-haptic group where they received virtual reality headset-based educational modules with or without haptic feedback hand controllers (depending on their grouping). This was followed by the drilling of a benchtop simulated cortical bone model. Cortical bone drilling was selected for the trial as it is a key skill in orthopedic surgery. Outcomes including drill plunge depth, objective structured assessment of technical skill (OSATS) ratings, and participant feedback were considered. This study was carried out in accordance with CONSORT guidelines and with institutional approval.

The results of this study suggest an amelioration of learning curve, wherein 46% of the haptic-trained group exhibited outcomes suggestive of an achieved plateau phase beyond the initial learning curve compared with 6% of the non-haptic trained group, and superior outcomes, with a 44% reduction in plunge depth of the drill bit beyond target tissues.  Researchers also reported a significantly higher percentage of subjects achieving safe drill depths and better expert-rated performance with higher OSATS scores.

This study demonstrates superior performance for a bone drilling task when taught using a VR-based simulation model incorporating haptic feedback, compared to one without haptics, supporting the pursuit and implementation of haptics in surgical training simulation models to improve their educational value. It has shown that haptic feedback plays a key role to ensure the surgeon stops drilling just as the drill bit breaches the far side of the bone, resulting in a sudden release of resistance as the bone is penetrated, so as to prevent damage to adjacent soft tissue and vasculature.

“We are delighted to see the results of this study published in an excellent journal such as Annals of Medicine and Surgery. It tangibly demonstrates the benefits of haptics and VR in lowering the learning curve and increasing skills transfer.”

Richard Vincent, co-founder and CEO of FundamentalVR

By creating low-cost immersive simulations, FundamentalVR continues to work towards providing ‘pre-human competence’ and lowering the learning curve, providing safe places to practice and better patient outcomes. Through CollaborationVR, HapticVR™, and other features on the Fundamental Surgery platform, FundamentalVR ensures that personnel are given the dynamic environment needed to explore patient cases, anatomy, devices, procedures, and more to achieve their learning goals. Including implementing virtual products, which customers can build as direct replicas of real-life devices.

For further information about this study, read here.