Validation for effectiveness of the virtual reality based simulator for training of Neophyte on oocyte retrieval/ovum pickup


V. Bhat1 , P. Waghmare2 , V. Rengarajan2 , P. Ponnuvel2 , V. Iyengar2 , C. Kumar2 .
1Radhakrishna Multispeciality Hospital & IVF Center, Gynaecologist & Obstetrician, Bangalore, India. 2Reprosci Biosciences Private Limited, Research & Development, Bangalore, India.

Study Question

To evaluate and measure the clinicians’ performance in oocyte pick-up procedures by using a VR-based simulator before they perform the procedure on real patients.

Summary Answer

Clinicians' oocyte pick-up performance significantly improved with the virtual reality simulator—evidenced by heightened accuracy, enhanced hand-eye coordination, and reduced procedure time.

What is Known Already

Virtual reality simulators hold immense potential in transforming medical training, providing a secure space for neophyte practitioners to repetitively practice procedures without the involvement of live subjects. However, despite their promise, there is a lack of rigorous evaluation regarding the translation of skills acquired on these platforms into improved clinical outcomes, such as oocyte retrieval. A critical need for comprehensive assessments to determine the effectiveness of virtual reality simulators in enhancing real-world clinical skills and ensuring their impact on patient care.

Validation

Validation for effectiveness of the virtual reality-based simulator for training of Neophyte on oocyte retrieval/ovum pickup.

Study Design, Size, Duration

The study utilized a quasi-experimental design, incorporating a 60-minute theoretical and 45-minute simulator training program for oocyte retrieval. A total of 40 participants were split into two groups, each consisting of 20 individuals, experiencing a 4-hour and 8-hour simulation session. Following the allocated training hours, participants completed questionnaires covering demographics, first impressions of the VR simulator, and its perceived usefulness. Participant performance was subsequently scored after completion of training.

Participants/Materials, Setting, Methods

Forty neophyte participants, with master's in Obstetrics-Gynecology, were divided into two groups for simulation training on oocyte pick-up using a virtual reality-based simulator.

Performance parameters assessed included the total number of times the vaginal and ovary walls were pierced, the total number of aspirated follicles, remaining follicles, compromised follicles, blood aspiration count, and aspiration efficiency. These metrics aimed to comprehensively evaluate and measure participants' proficiency in oocyte pick-up procedures using the virtual reality simulator.

Main Results and the Role of Chance

The results show that training with the virtual reality-based simulator significantly enhanced clinician performance when performing oocyte pick-up. In the second group, there was a significant increase in the percentage of correctly aspirated follicles 77% vs. In the first group, 60% of correctly aspirated follicles (p < 0.05), while accompanied by a significant decrease in aspirating follicles time (26 s vs. 38 s, p < 0.05). This translated into improved accuracy of performance on the whole (2.77% vs 1.56%, p < 0.05). Furthermore, those in the second group significantly improved their performance time-wise (20s vs. 35s, p <0.05), although the level of aspirated follicles remained about the same mean number. These improvements are unlikely to be attributed to chance, as the differences observed between the two groups are statistically significant. These findings are also supported by the study design itself, which divided participants according to two teams undergoing various durations of simulation training. The fact that the trends of improvement in speed and accuracy across sessions support the argument against chance also provides additional evidence, suggesting that use of a virtual reality-based simulator has consistent meaningful impact on clinician performance during oocyte retrieval procedures.

Limitations, Reasons for Caution

The study's limitations include a small sample size, a focus on Neophyte participants without expert group involvement, and the absence of more complicated ultrasound cases in oocyte pickup scenarios. Considering these outcomes are relatively small and highly sensitive to their groups, further research of larger and diverse group is warranted.

Wider Implications of the Findings

Virtual reality simulators have a transformative impact on enhancing clinical competency in oocyte pick-up. The observed improvements in accuracy and efficacy in simulations imply practical implications for real clinical practice. Requirement of extensive studies with diverse participants is crucial, confirming initial positive results and unveiling enduring effects in clinical settings.