Or Fire Virtual Training Simulator: Design and Face Validity

Denis Dorozhkin1, Daniel B Jones2, Steven D Schwaitzberg3, Stephanie B Jones4, Caroline L Cao5, Jaisa Olasky6, Marcos Molina2, Steven Henriques2, Jinling Wang5, Jeff Flinn5, Suvranu De1. 1Center for Modeling, Simulation and Imaging in Medicine (CeMSIM), Rensselaer Polytechnic Institute, Troy, NY, USA, 2Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA, 3Department of Surgery, University at Buffalo, The State University of New York, Buffalo, NY, USA, 4Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA, 5Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH, USA, 6Department of Surgery, Mount Auburn Hospital, 300 Mount Auburn Street Suite 407, Cambridge, MA, USA

INTRODUCTION: The Virtual Electrosurgical Skill Trainer (VEST) is being developed as a tool for training surgeons the safe operation of electrosurgery tools in both open and minimally invasive surgery. This training includes a dedicated team-training module that focuses on operating room (OR) fire prevention and response. The module was developed to allow trainees as well as practicing surgeons, anesthesiologists, and nurses to interact with a virtual OR environment that includes anesthesia apparatus, electrosurgical equipment, a virtual patient, and a fire extinguisher. Wearing a head mounted display, participants demonstrate knowledge of potential fire hazards by correctly identifying the ‘fire triangle’ elements and then successfully containing an OR fire caused by an oxygen (O2) enriched environment under the surgical drape. Within these virtual reality (VR) scenarios, trainees learn to react appropriately to a simulated fire emergency. An initial set of validation studies, targeted at establishing the face validity of the virtual OR fire simulator, was undertaken at the 2015 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) conference.

METHODS AND PROCEDURE: Forty nine subjects (n=49) with varying electrosurgical experience participated in this Institutional Review Board (IRB) approved study. The subjects were asked to complete the OR fire training/prevention sequence in the VEST simulator. The subjects were then asked to answer a subjective preference questionnaire, focused on the usefulness and fidelity of the simulator.

RESULTS: On a 5-point scale, 12 out of 13 questions were rated at the mean value of 3 or greater (92%). Five questions were rated above 4 (38%), particularly those focusing on simulator effectiveness and its usefulness in OR fire safety training. 33 of the 49 participants (67%) chose the virtual OR fire trainer over the traditional training methods, such as a textbook or an animal model.

CONCLUSIONS: Training for OR fire emergencies in fully-immersive virtual reality environments may be the ideal training modality, and the VEST OR fire trainer was developed for this task. The results of this study indicate a high level of importance associated with the virtual reality electrosurgical trainer by the participating physicians. The face validity of the OR fire training module of the VEST simulator was successfully established on many aspects of the simulation. 

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