Back to the future: surgical rehearsal platform technology as a means to improve surgeon-patient alliance, patient satisfaction, and resident experience

Abstract

OBJECTIVEInformed consent, when performed appropriately, serves many roles beyond simply obtaining the prerequisite medicolegal paperwork to perform a surgery. Prior studies have suggested that patient understanding is poor when verbal communication is the sole means of education. Virtual reality platforms have proven effective in enhancing medical education. No studies exist that have demonstrated the utility of virtual reality–facilitated informed consent (VR-IC) in improving the physician-patient alliance. The aim of this study was to determine the utility of VR-IC among patients providing consent for surgery and the impact of this educational and information technology–based strategy on enhancing the physician-patient alliance, patient satisfaction, and resident-physician perception of the consent process.METHODSProspective, single-site, pre- and postconsent surveys were administered to assess patient and resident perception of informed consent performed with the aid of VR-IC at a large tertiary academic medical center in the US. Participants were adult patients (n = 50) undergoing elective surgery for tumor resection and neurosurgical residents (n = 19) who obtained patient informed consent for these surgical procedures. Outcome measures included scores on the Patient-Doctor Relationship Questionnaire (PDRQ-9), the modified Satisfaction with Simulation Experience Scale, and the Maslach Burnout Inventory. Patient pre- and postconsent data were recorded in real time using a secure online research data platform (REDCap).RESULTSA total of 48 patients and 2 family members provided consent using VR-IC and completed the surveys pre- and postconsent; 47.9% of patients were women. The mean patient age was 57.5 years. There was a statistically significant improvement from pre- to post–VR-IC consent in patient satisfaction scores. Measures of patient-physician alliance, trust, and understanding of their illness all increased. Among the 19 trainees, perceived comfort and preparedness with the informed consent process significantly improved.CONCLUSIONSVR-IC led to improved patient satisfaction, patient-physician alliance, and patient understanding of their illness as measured by the PDRQ-9. Using VR-IC contributed to residents’ increased comfort in the consent-gathering process and handling patient questions. In an era in which satisfaction scores are directly linked with hospital and service-line outcomes and reimbursement, positive results from VR-IC may augment physician and hospital satisfaction scores in addition to increasing measures of trust between physicians and patients.

Patient Safety in Hysteroscopic Procedure

“…[ 8 ] Informed consent, a fundamental tenet of surgical practice, is an opportunity to simultaneously build the patient–physician relationship and improve patient education and understanding of their illness. [ 16 ]…”

“…[ 17 ] Conversations regarding informed consent necessarily rely on the rapport between the consenting patient and the surgeon. [ 16 ]…”

“…However, no such benefit was noted in postmenopausal women. [ 16 ] The use of preoperative misoprostol reduced rates of false passage formation but did not reduce rates of uterine perforation during operative hysteroscopy. [ 6 ]…”

Extended reality platform for minimally invasive endoscopic evacuation of deep-seated intracerebral hemorrhage: illustrative case

“…For neurovascular surgery, the XR platform described here has been successfully used for patient engagement, preoperative planning, intraoperative visualization, and evaluation of postaneurysm clipping or endovascular intervention. [11][12][13] Diagnostic imaging studies such as computed tomography (CT), CT angiography (CTA), or digital subtraction angiography can be fused to build a comprehensive and interactive 360XR model. 12 In this case, the 360XR model assisted the surgeon in planning in VR and provided a direct trajectory to the deep-seated IPH that avoided critical structures, enhanced by magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI).…”

“…[11][12][13] Diagnostic imaging studies such as computed tomography (CT), CT angiography (CTA), or digital subtraction angiography can be fused to build a comprehensive and interactive 360XR model. 12 In this case, the 360XR model assisted the surgeon in planning in VR and provided a direct trajectory to the deep-seated IPH that avoided critical structures, enhanced by magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI). In the operating room, the XR platform's AR solution for endoscopic surgeries was used to provide intraoperative guidance via AR overlay of the 360XR model.…”