Virtual reality brings doc training to life

I held the mallet firmly in my hand and brought it toward the nail sticking out of the patient's leg.

I tapped.

I tapped harder, forcing the nail downward as sweat trickled down my back.

I am not, as you surely know, a surgeon. I am not any kind of clinician. But I am a person capable of donning a virtual reality headset and gripping two VR controllers. Immersed in a virtual operating room, I inserted a nail into a patient's tibia.

The simulation—the same as a surgeon might go through—came from Osso VR, a company that works with medical-device makers and creates simulation modules to teach surgeons how to use new surgical tools.

“What we're hoping to provide for medical-device startups is a scalable, affordable, and more effective training solution to more rapidly train their users,” said Dr. Justin Barad, CEO and co-founder of Osso VR.

Research from the World Health Organization, ECRI Institute and others have shown that as medical devices become more complex, users frequently lack sufficient training. In traditional approaches, manufacturer representatives or surgeons who already know how to use the device give new users a couple hours of training, and then leave them on their own.

Months later, clinicians might perform their first surgeries using the new tools, Barad said. “What's happening now is that surgeons and providers are practicing on patients,” he said. “They're working their way up the learning curve,” he added, noting that for some technologies, it takes upwards of 50 cases to reach proficiency.

“Typically, training has been limited to very rudimentary things, like reading or videos that don't really provide that hands-on experience,” said Dr. Nelson SooHoo, an orthopedic surgeon at UCLA Health and a member of Osso VR's advisory board. “As a surgeon, what I'm looking for is not something novel, but something familiar.” Sometimes, physicians get to work with cadavers, but that kind of training can be expensive and time-consuming.

Barad and Matt Newport launched Osso VR in 2016 to respond to holes in surgical training. “We're trying to fill that training gap,” Barad said. Not only can Osso VR's simulations be repeated over and over until a surgeon is comfortable with the medical device, they also can be done at more convenient times, not just when the medical-device rep is available to lead training.

“With VR and other forms of simulation, you can go through scenarios in a relatively quick and focused manner,” said Jim Piepenbrink, deputy executive director of the Association for the Advancement of Medical Instrumentation, who also praised VR's ability to give trainees environmental context. “If you don't keep your skills sharp, that's where error comes in.”

In that way, the system is similar to any video game that rewards practice. That's no accident, since before Barad got into bio-engineering and orthopedic surgery, he wanted to be a game developer. He even found his co-founder on an Oculus Rift message board, and many of Osso VR's employees have backgrounds in gaming.

“We're applying gaming practices and thinking to problem solving,” Barad said. “People haven't thought of doing it in that way before.”

The company also draws on the work of medical illustrators and clinicians. It helps that Barad himself was a surgeon before starting the business. “Communication is one of the biggest issues in startups,” he said. “The fact that I'm able to communicate with our development team in their language and translate the science and medicine part helps.”

The technology is still catching on, but Barad is confident, noting that the company is in talks with a “top-five orthopedic device company.” Osso VR is also targeting early-stage companies transitioning into the commercial space.

For these companies, Barad said, “The training bottleneck is one of the biggest issues.” And given shrinking reimbursements, increasing patient demand and the burden of dealing with electronic health records, physicians are struggling to even find time for training courses, not to mention to excel at them, Barad said.

“Device companies need to find a way to get a better return on their education,” he said. “That's what we're trying to do for them.”