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Accepted for/Published in: JMIR Medical Education

Date Submitted: Sep 5, 2024
Open Peer Review Period: Sep 6, 2024 - Nov 1, 2024
Date Accepted: Apr 6, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study

Mazur L, Butler L, Mitchell C, Lashani S, Buchanan S, Fenison C, Adapa K, Ra J

Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study

JMIR Med Educ 2025;11:e66186

DOI: 10.2196/66186

PMID: 40311122

PMCID: 12061349

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Effect of Immersive Virtual Reality TeamSTEPPS Training on Safety Behaviors During Surgical Cases: Non-randomized Intervention vs. Control Pilot Study

  • Lukasz Mazur; 
  • Logan Butler; 
  • Cody Mitchell; 
  • Shaian Lashani; 
  • Shawna Buchanan; 
  • Christi Fenison; 
  • Karthik Adapa; 
  • Jin Ra

ABSTRACT

Background:

Approximately 4000 preventable surgical errors occur per year in the US operating rooms (ORs), many due to suboptimal teamwork and safety behaviors.

Objective:

There is a need to develop and quantify the effect of innovative and immersive training intervention on safety behaviors of surgeons in the operating rooms (ORs).

Methods:

This pilot study was conducted in a large academic medical center with 55 ORs. Safety behaviors were observed and quantified using validated Teamwork Evaluation of Non-Technical Skills (TENTS) instrument during surgical cases at baseline (101 observations; n=83 physicians) and post immersive virtual reality (VR) based intervention (post intervention: 24 observations within each group: intervention group (with VR training; n=10 physicians) and control (no VR training; n=10 physicians)). VR 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 with adjustments for multiplicity of the tests was used to test for significance in observable safety behaviors 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; 0-3 scale). The ten physicians that underwent our intervention showed statistically significant 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:

VR-based immersive training intervention focused on TeamSTEPPS principles seems effective in improving safety behaviors in the ORs as quantified via observations using the TENTS instrument. Clinical Trial: None


 Citation

Please cite as:

Mazur L, Butler L, Mitchell C, Lashani S, Buchanan S, Fenison C, Adapa K, Ra J

Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study

JMIR Med Educ 2025;11:e66186

DOI: 10.2196/66186

PMID: 40311122

PMCID: 12061349

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