Osso VR, a virtual reality surgical training platform, announced on June 15, 2018 partnerships with top U.S. medical residency programs to provide hands-on training opportunities for new surgeons using VR. The Vanderbilt University School of Medicine’s orthopedic residency program brings to eight the number of programs deploying the Osso VR training solution. This expansion into surgical residency programs comes on the heels of the company’s success in working with medical device companies looking to improve training, encourage safe use, and increase adoption. Other orthopedic residency programs using Osso VR include Long Island Jewish Medical Center, Columbia University, David Geffen School of Medicine at UCLA, Harvard Medical School and Hospital for Special Surgery.
The leg is virtual, the tools are real in Osso VR’s orthopedic surgery simulations for medical residents.
One of the chief obstacles to adoption of VR training has been the structure of the healthcare industry. Surgeons don’t feel they need training, and even if they did, who would pay for their time? The hospital? An insurance company? The government? All the stakeholders benefit from improved outcomes, but none think they should bear the cost. The one group that does think they need training and indeed pays for it, is medical students, interns, and residents. This may well be the sweet spot for Osso’s surgical simulations. The introduction of Osso to these leaders of the future may pave the way for VR training across the healthcare industry.
“Osso VR augments the apprenticeship training model the surgical education system has relied on for over a century,” said Dr. Justin Barad, Osso’s founder, CEO, and orthopedic surgeon. He was a video game programmer before he became a surgeon and saw how his old profession might help his new one. “It’s been proven that VR training improves outcomes for new surgeons. I had to learn through observation instead of experience. Simulation is clearly a better, safer, and more consistent way to accomplish that.”
Dr. Justin Barad, founder and CEO of Osso VR. Their orthopedic surgery simulation is being adopted by medical schools across the country.
“The experience of a trainee is completely dependent upon chance; the chance that their hospital cares for the number and variety of trauma and elective cases needed and other elements important to training. Using VR we can remove the variable chance while allowing individually paced learning.” said Dr. Jonathan Schoenecker, Assistant Professor of Orthopaedics at Vanderbilt University School of Medicine.
“At this point, we’ve found that the challenges around training are becoming so large that VR training is turning into a need-to-have solution,” Dr. Barad continued. “When 30 percent of residency graduates still can’t do the job they spent nearly a decade preparing for, something needs to change.”
Medical Students welcome the new technology, which allows them to perfect their practice before turning to a real patient.
VR allows the trainee to physically learn, practice, and master the proper steps of a procedure. With the current work-hour restrictions in medical training, VR levels the playing field by challenging the user to physically and mentally walk through the operation. “I have not performed any surgeries on my own yet,” Samuel Posey, MD candidate at Vanderbilt University School of Medicine, told me in an email, “however, many surgeons do not have the time to explain all the steps of a procedure to a student assisting them. Having this technology to simulate cases prior to walking in the OR would not only provide a fantastic way to learn anatomy but also allow for a better understanding of how to be a better assistant.
Osso VR also allows for surgical mastery to finally be measured. Currently, assessment during residency is based upon objective measures of knowledge through standardized testing, but the actual surgical skills of trainees are still mainly assessed through subjective mentor observation. Osso VR plans to introduce new modules for programs to use that cover a range of surgical skills and procedures from the basic to the complex. In addition, residents will have the opportunity to learn about potential problems that a surgeon may encounter during a procedure. “Not only will this greatly enhance the ability to produce skilled orthopedic surgeons, but also reduce the time of training and increase the capacity to assess skill. Most importantly, this should lead to safer clinical practice,” said Dr. Schoenecker.
“With early versions of our software, we have already found that VR-trained users perform surgery twice as well when compared with non-VR trained individuals as measured by the Global Rating Scale. This scoring system has been validated by multiple peer-reviewed publications and grades surgeons according to Time and Motion, Instrument Handling, Knowledge of Instruments, Flow of Operation and Forward Planning, and Knowledge of Specific Procedure. Because the solution is exponential rather than incremental, there is a stronger case for change,” Dr. Barad says.
Overturning dogma is always a challenge, especially within medicine. Barad told me there are three dynamics in play that signal a new readiness for change: (1) The problem is getting too big to ignore. (2) The solution/technology is so effective it can solve the problem exponentially better than prior approaches. (3) There is increasing comfort with frontier technologies.
The growing ubiquity of VR, AR, 3d printing, and smartphones have made many stakeholder groups within medicine much more comfortable with disruptive innovation. While these dynamics are very good for Osso, it also presents a bigger challenge: meeting the demand for surgical VR training content. “What makes Osso VR special is that we have spent the past year and a half developing a proprietary toolset that lets us parallelize our development so that we can rapidly create and deploy VR training experiences for our users in a scalable way,” Dr. Barad explained.
“Many of the basic, essential skills that we learn in the first year of residency can be learned, perfected, and evaluated in just hours in a virtual operating room,” said Jeffrey Hills, MD, Vanderbilt Orthopedic Resident. “There will be people that doubt its utility. There will be people that are old-school and say that there is no replacement to getting into the cadaver lab and practicing on real anatomy. I would not disagree with this — however, perfecting certain skills or reviewing the surgical approach through a quick session in the virtual operating room, will make you even more efficient in the cadaver lab, and ultimately more efficient in the operating room.”