Does your team know how to respond safely to an operating room fire? Outcomes of a virtual reality, AI-enhanced simulation training.

BACKGROUND: Operating room (OR) fires are rare but devastating events requiring immediate and effective response. Virtual Reality (VR) simulation training can provide a safe environment for practice of skills in such highly stressful situation. This study assessed interprofessional participants' ability to respond to VR-simulated OR fire scenarios, attitudes, numbers of attempt of the VR simulation do participants need to successfully respond to OR fires and does prior experience, confidence level, or professional role predict the number of attempts needed to demonstrate safety and pass the simulation. METHODS: 180 surgical team members volunteered to participate in this study at Beth Israel Deaconess Medical Center, Boston, MA. Each participant completed five VR OR simulation trials; the final two trials incorporated AI assistance. Primary outcomes were performance scores, number of attempts needed to pass, and pre- and post-survey results describing participant confidence and experiences. Differences across professional or training role were assessed using chi-square tests and analyses of variance. Differences in pass rates over time were assessed using repeated measures logistic regression. RESULTS: One hundred eighty participants completed simulation testing; 170 (94.4%) completed surveys. Participants included surgeons (17.2%), anesthesiologists (10.0%), allied health professionals (41.7%), and medical trainees (31.1%). Prior to training, 45.4% of participants reported feeling moderately or very confident in their ability to respond to an OR fire. Eight participants (4.4%) responded safely on the first simulation attempt. Forty-three participants (23.9%) passed by the third attempt (VR only); an additional 97 participants (53.9%) passed within the 4-5th attempt (VR with AI assistance). CONCLUSIONS: Providers are unprepared to respond to OR fires. VR-based simulation training provides a practical platform for individuals to improve their knowledge and performance in the management of OR fires with a 79% pass rate in our study. A VR AI approach to teaching this essential skill is innovative, feasible, and effective.

Virtual reality operating room with AI guidance: design and validation of a fire scenario.

BACKGROUND: Operating room (OR) fires are uncommon but disastrous events. Inappropriate handling of OR fires can result in injuries, even death. Aiming to simulate OR fire emergencies and effectively train clinicians to react appropriately, we have developed an artificial intelligence (AI)-based OR fire virtual trainer based on the principle of the "fire triangle" and SAGES FUSE curriculum. The simulator can predict the user's actions in the virtual OR and provide them with timely feedback to assist with training. We conducted a study investigating the validity of the AI-assisted OR fire trainer at the 2019 SAGES Learning Center. METHODS: Fifty-three participants with varying medical experience were voluntarily recruited to participate in our Institutional Review Board approved study. All participants were asked to contain a fire within the virtual OR. Participants were then asked to fill out a 7-point Likert questionnaire consisting of ten questions regarding the face validation of the AI-assisted OR fire simulator. Shapiro-Wilk tests were conducted to test normality of the scores for each trial. A Friedman's ANOVA with post hoc tests was used to evaluate the effect of multiple trials on performance. RESULTS: On a 7-point scale, eight of the ten questions were rated a mean of 6 or greater (72.73%), especially those relating to the usefulness of the simulator for OR fire-containing training. 79.25% of the participants rated the degree of usefulness of AI guidance over 6 out of 7. The performance of individuals improved significantly over the five trials, χ2(4) = 119.89, p < .001, and there was a significant linear trend of performance r = .97, p = 0.006. A pairwise analysis showed that only after the introduction of AI did performance improve significantly. CONCLUSIONS: The AI-guided OR fire trainer offers the potential to assess OR personnel and teach the proper response to an iatrogenic fire scenario in a safe, repeatable, immersive environment.

Disruptions to shared mental models from poor quality of service in collaborative virtual environments.

Collaborative virtual environments are being used in various applications ranging from online games to complex team training scenarios. The key to the success of such environments is the ability of the participants to form a shared mental model of the collaborative task being performed. Poor quality of service can deteriorate user performance and quality of experience, leading to a disruption of this mental model. While the effects of quality of service have been analyzed for traditional desktop environments, these effects remain unclear in collaborative virtual environments during user-to-user interactions. Here, we analyze the role of latency and packet bursts, two common problems in collaborative applications, on both simulator perception and actual task performance in a collaborative fire-fighting simulator. This exploratory study indicates that large latencies have a significant (p < 0.05) impact on the quality of experience, but not task performance. In contrast, packet bursts have a much larger impact on both the quality of experience and performance. Additionally, the network role, such as whether a user is a client or server, showed a significant (p < 0.05) impact on task performance in conditions impaired by packet bursts.