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Clinical Readiness: Can Providers Learn to Perform Lower Leg Fasciotomy Through a Tablet-based Augmented Reality
Kieran Wolf1, Mark Bowyer1, Matthew Bradley1
1Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.
Military Medicine
|March 30, 2024
Summary
Tablet-based augmented reality (AR) training improved surgical knowledge and skills but did not enable novice trainees to perform a lower leg fasciotomy on a cadaver. The AR interface limitations hindered the transfer of learning to real-world surgical performance.
Area of Science:
- Medical Education
- Surgical Training
- Augmented Reality (AR) in Medicine
Background:
- On-demand, interactive tablet-based surgical training is explored for acquiring and maintaining critical procedures.
- Expeditionary surgical care necessitates effective training for rarely performed procedures.
Purpose of the Study:
- To examine the effectiveness of a tablet-based AR training environment for lower leg fasciotomy.
- To assess the impact on novice surgical trainees' procedural knowledge, tablet-based skills, time, and cadaver performance.
Main Methods:
- 30 novice surgical trainees participated in tablet-based AR training, including pre- and post-assessments.
- Knowledge was assessed via multiple-choice questions; procedural skills and time were measured within the AR environment.
- Participants' ability to perform lower leg fasciotomy on a cadaver was evaluated by fellowship-trained trauma surgeons.
Main Results:
- AR training significantly improved procedural knowledge (P<.001) and tablet-based skills (P<.001), with large effect sizes.
- Procedural time on the tablet was significantly reduced (P<.002), with a small effect size.
- No significant transfer of knowledge, skills, or time improvements to cadaver-based performance was observed; no participant completed the procedure on a cadaver.
Conclusions:
- Tablet-based AR training enhances procedural knowledge and in-app skills but does not translate to actual surgical performance in novice trainees.
- The AR interface's limitations in simulating surgical technique, tissue handling, and decision-making prevent skill acquisition for cadaver performance.
- Further research is needed to determine the utility of tablet-based AR training for surgical readiness, especially for experienced surgeons.
