JMIR Publications

ABSTRACT

Background:

Care providers and surgeons prepare for cardiac surgery using case conferences to review, discuss and run through the surgical procedure. Surgeons visualize a patient’s anatomy to decide the right surgical approach using Magnetic Resonance Imaging and Echocardiograms in a pre-surgical case planning session. Previous studies have shown that surgical errors can be reduced through the effective use of immersive Virtual Reality (VR) to visualize patient anatomy. However, inconsistent user interfaces, delegation of view control, and insufficient depth information cause user disorientation and interaction difficulties in using VR applications for case planning.

Objective:

The objective of the study was to evaluate and compare the usability of two commercially-available VR applications—Bosc and Medical Holodeck—using the HTC Vive VR headset to evaluate ease of use, physician attitudes towards VR technology, and viability for pre-surgical case planning. The role of medical libraries in advancing case planning is also explored.

Methods:

After screening a convenience sample of surgeons, fellows, and residents, ethnographic interviews were conducted to understand physician attitudes and experience with VR. Gaps in current case planning methods were also examined. We ran a usability study, employing a concurrent think aloud protocol. To evaluate user satisfaction, we used the System Usability Scale (SUS) and the National Aeronautics and Space Administration-Task Load Index (NASA-TLX). A post study questionnaire was used to evaluate the VR experience and explore the role of medical libraries in advancing pre-surgical case planning. Semi-structured interview data were analyzed using content analysis with feedback categorization

Results:

Participants were residents, fellows, and surgeons from the University of Washington with a mean age of 41.5 (SD=11.67) years. A total of eight surgeons participated in the usability study, three of whom had a prior exposure to VR. Users found Medical Holodeck easier to use than Bosc. Mean adjusted NASA TLX score for Medical Holodeck was 62.71(SD=18.25) vs. Bosc’s 40.87(SD=13.90). Neither application passed the mean SUS score of 68 for an application to be considered usable, though Medical Holodeck (66.25(SD=12.87)) scored a higher mean SUS than Bosc (37.19(SD=22.41)). One user rated the Bosc usable, while three users rated Medical Holodeck usable

Conclusions:

Interviews highlighted the importance of precise anatomical conceptualization in pre-surgical case planning and teaching, identifying it as the top reason for modifying a surgical procedure. The importance of standardized user interaction features such as labeling is justified. The study also sheds light on the new roles medical librarians can play in curating VR content and promoting interdisciplinary collaboration.