Abstract
Introduction
The extensive resources needed to train surgeons and maintain skill levels in low-income and middle-income countries (LMICs) are limited and confined to urban settings. Surgical education of remote/rural doctors is, therefore, paramount. Virtual reality (VR) has the potential to disseminate surgical knowledge and skill development at low costs. This study presents the outcomes of the first VR-enhanced surgical training course, ‘Global Virtual Reality in Medicine and Surgery’, developed through UK-Ugandan collaborations.
Methods
A mixed-method approach (survey and semistructured interviews) evaluated the clinical impact and barriers of VR-enhanced training. Course content focused on essential skills relevant to Uganda (general surgery, obstetrics, trauma); delivered through: (1) hands-on cadaveric training in Brighton (scholarships for LMIC doctors) filmed in 360°; (2) virtual training in Kampala (live-stream via low-cost headsets combined with smartphones) and (3) remote virtual training (live-stream via smartphone/laptop/headset).
Results
High numbers of scholarship applicants (n=130); registrants (Kampala n=80; remote n=1680); and attendees (Kampala n=79; remote n=556, 25 countries), demonstrates widespread appetite for VR-enhanced surgical education. Qualitative analysis identified three key themes: clinical education and skill development limitations in East Africa; the potential of VR to address some of these via 360° visualisation enabling a ‘knowing as seeing’ mechanism; unresolved challenges regarding accessibility and acceptability.
Conclusion
Outcomes from our first global VR-enhanced essential surgical training course demonstrating dissemination of surgical skills resources in an LMIC context where such opportunities are scarce. The benefits identified included environmental improvements, cross-cultural knowledge sharing, scalability and connectivity. Our process of programme design demonstrates that collaboration across high-income and LMICs is vital to provide locally relevant training. Our data add to growing evidence of extended reality technologies transforming surgery, although several barriers remain. We have successfully demonstrated that VR can be used to upscale postgraduate surgical education, affirming its potential in healthcare capacity building throughout Africa, Europe and beyond.
| Original language | English |
|---|---|
| Article number | e002477 |
| Journal | BMJ Open Quality |
| Volume | 13 |
| Issue number | 1 |
| Early online date | 29 Jan 2024 |
| DOIs | |
| Publication status | Published - 30 Mar 2024 |
Bibliographical note
Funding Information:Thanks to BSMS (Brighton and Sussex Medical School) dissection lab, for providing cadaveric specimens for the pilot and main course, and anatomical support, as well as hosting.Thanks to ACE at IDI (African Centre of Excellence in Bioinformatics and Data Science at the Infectious Diseases Institute, Makerere University and UCU (Uganda Christian University, School of Medicine) for providing venues in Kampala, inclusive of data, free-of-charge for 4 days, as well as technical support (and VR headset provision by ACE). In particular thanks to technical faculty: Grace Kebirungi, Patricia Nabisubi, Henry Mutegeki.Thanks to Medical Realities for providing low-cost cardboard VR headsets and covered shipping costs for the pilot and main event (100×headsets delivered to Kampala). Thanks to partnership with GASOC (the Global Anaesthesia, Surgery and Obstetrics Collaborative, UK-based) who provided contacts with surgeons and doctors throughout Uganda, and other countries to act as faculty and consultants for course design. Thanks to partnership with Mengo Hospital and FOMHUK (Friends of Mengo Hospital UK, a registered UK Charity) for providing Ugandan surgical faculty. Thanks to all our partners for advertising efforts, including BSMS, ACE, UCU, GASOC, Mengo Hospital; ASOU (Association of Surgeons of Uganda); COSECSA (College of Surgeons of Eastern Central and Southern Africa) and NTV Uganda. Thanks to all surgical faculty involved in teaching on the pilot and main course (UK, Uganda and virtual/remote, names listed in Supplementary File Course Programme). Thanks to Saving Faces (The Facial Surgery Research Foundation, a registered UK Charity) provided funding for scholarships (10×£1500) to successful scholars to subsidise flights from East Africa and accommodation in Brighton to attend the course. No award/grant number (charitable donation). VRiMS (Virtual Reality in Medicine and Surgery), UK provided funding for food/refreshments, a publicity banner and several other overhead costs required for the Kampala-based course. No award/grant number (charitable donation).
Publisher Copyright:
© Author(s) (or their employer(s)) 2024.