Association Between Immersive Virtual Reality Patient Safety Training and Safety Behaviors During Surgical Cases
Lukasz Mazur, PhD | Professor and Director
School of Medicine and Division of Healthcare Engineering-University of North Carolina at Chapel Hill
*Zero Harm and Excellence in Patient Care*
Dr. Lukasz Mazur earned his BS, MS and PhD in industrial and management engineering from Montana State University. He is a professor and a director of Healthcare Engineering Department at the Radiation Oncology Department in the UNC School of Medicine with a joint appointment in the School of Information and Library Science (SILS) His research interests include engineering management as it pertains to continuous quality, wellbeing and patient safety efforts in healthcare and human factor engineering with a focus on workload and individual performance during human-machine interactions. While at the North Carolina State University, Lukasz was awarded the prestigious Alumni Outstanding Extension Service Award for his outreach work in healthcare industry, highlighting his passion for spearheading practical change and creating economic impact. He published >50 peer review papers, >100 conference proceedings abstracts, five book chapters, and co-authored one book. Lukasz was also inducted into the hall of fame as a player and assistant coach for his efforts on the tennis team at the Montana State University.
Organization's Statics
UNC Health is an integrated health care system owned by the state of North Carolina and based in Chapel Hill. Known as “North Carolina’s Health Care System,” UNC Health provides care to patients in all of the state’s 100 counties through its 11 hospitals, 13 hospital campuses, and hundreds of clinical practices. It is one of the nation’s leading academic health care systems, a $5.4 billion enterprise, with more than 33,000 employees from Hendersonville to Jacksonville. Five adult specialties and seven children’s specialties at UNC Medical Center were nationally ranked by US News in its latest “Best Hospitals” and “Best Children’s Hospitals” reports.
Key Learning Objectives
After attending this talk
- Attendees will be able to understand how immersive virtual reality (VR) training can be used to improve teamwork behaviors in the operating rooms (ORs).
- Attendees will be able to understand how to measure teamwork behaviors in the operating rooms (ORs) using TeamSTEPPS principles and tools.
TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) is a teamwork system that aims to improve patient outcomes. It's based on research and principles from Crew Resource Management and High Reliability Organizations.
Study Design
Study was conducted in a large academic medical center with 55 ORs. 185 surgical cases were observed as part of a non-randomized control group pre- (101 observations; n=83 physicians) vs. post-analysis (24 observations within each group: intervention (n=10 physicians) and control (n=10 physicians)) of our innovative immersive virtual reality (VR) based educational intervention. Intervention included a 45-minute immersive VR-based training incorporating a pre- and post-debriefing based on Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) principles to improve safety behaviors. A two-tailed, two-sample t-test was with adjustments for multiplicity of the tests was used to test for significance between the groupings.
Results
Pre-intervention, all safety behaviors averaged slightly above acceptable scores, with an overall average of 2.2 (range 2.0-2.3). The ten physicians that underwent our intervention showed statistically significant (p<0.05) improvements in 90% (18/20) of safety behaviors when compared to the ten physicians that did not receive the intervention (overall average [range]: 2.5 [2.3-2.7] vs. 2.1 [1.9-2.2].
Conclusions
- Results suggest that our VR intervention could be effective at improving safety behaviors, as measured by the TENTS tool.
- It represents a scalable intervention to help reduce patient harm in the long run.
- A number of study limitations. Thus, further research with larger, more diverse sample sizes is needed to confirm the generalizability of these findings.
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