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

Abstract BackgroundApproximately 4000 preventable surgical errors occur per year in the US operating rooms, many due to suboptimal teamwork and safety behaviors. Such errors can result in temporary or permanent harm to patients, including physical injury, emotional distress, o...

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Main Authors: Lukasz Mazur, Logan Butler, Cody Mitchell, Shaian Lashani, Shawna Buchanan, Christi Fenison, Karthik Adapa, Xianming Tan, Selina An, Jin Ra
Format: Article
Language:English
Published: JMIR Publications 2025-05-01
Series:JMIR Medical Education
Online Access:https://mededu.jmir.org/2025/1/e66186
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author Lukasz Mazur
Logan Butler
Cody Mitchell
Shaian Lashani
Shawna Buchanan
Christi Fenison
Karthik Adapa
Xianming Tan
Selina An
Jin Ra
author_facet Lukasz Mazur
Logan Butler
Cody Mitchell
Shaian Lashani
Shawna Buchanan
Christi Fenison
Karthik Adapa
Xianming Tan
Selina An
Jin Ra
author_sort Lukasz Mazur
collection DOAJ
description Abstract BackgroundApproximately 4000 preventable surgical errors occur per year in the US operating rooms, many due to suboptimal teamwork and safety behaviors. Such errors can result in temporary or permanent harm to patients, including physical injury, emotional distress, or even death, and can also adversely affect care providers, often referred to as the “second victim.” ObjectiveGiven the persistence of adverse events in the operating rooms, the objective of this study was to quantify the effect of an innovative and immersive virtual reality (VR)–based educational intervention on (1) safety behaviors of surgeons in the operating rooms and (2) sense-making regarding the overall training experience. MethodsThis mixed methods pre- versus postintervention pilot study was conducted in a large academic medical center with 55 operating rooms. Safety behaviors were observed and quantified using validated Teamwork Evaluation of Non-Technical Skills instrument during surgical cases at baseline (101 observations; 83 surgeons) and postimmersive VR based intervention (postintervention: 24 observations within each group; intervention group [with VR training; 10 surgeons] and control [no VR training; 10 surgeons]). VR intervention included a 45-minute immersive VR-based training incorporating a pre- and postdebriefing based on Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) principles to improve safety behaviors. A 2-tailed, 2-sample t ResultsPreintervention, all safety behaviors averaged slightly above “acceptable” scores, with an overall average of 2.2 (range 2‐2.3; 0‐3 scale). The 10 surgeons that underwent our intervention showed statistically significant (P ConclusionsVR-based immersive training intervention focused on TeamSTEPPS principles seems effective in improving safety behaviors in the operating rooms as quantified via observations using the Teamwork Evaluation of Non-Technical Skills instrument. Further research with larger, more diverse sample sizes is needed to confirm the generalizability of these findings.
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publishDate 2025-05-01
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spelling doaj-art-3f2e7723d78f4d43896e3e03d09545272025-08-20T02:28:18ZengJMIR PublicationsJMIR Medical Education2369-37622025-05-0111e66186e6618610.2196/66186Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot StudyLukasz Mazurhttp://orcid.org/0000-0001-9793-7999Logan Butlerhttp://orcid.org/0000-0002-6487-0414Cody Mitchellhttp://orcid.org/0009-0008-1667-9528Shaian Lashanihttp://orcid.org/0009-0008-9628-180XShawna Buchananhttp://orcid.org/0000-0002-1214-5640Christi Fenisonhttp://orcid.org/0000-0001-8541-4162Karthik Adapahttp://orcid.org/0000-0002-3970-588XXianming Tanhttp://orcid.org/0000-0002-5478-2269Selina Anhttp://orcid.org/0000-0002-6131-9037Jin Rahttp://orcid.org/0000-0003-0334-9016 Abstract BackgroundApproximately 4000 preventable surgical errors occur per year in the US operating rooms, many due to suboptimal teamwork and safety behaviors. Such errors can result in temporary or permanent harm to patients, including physical injury, emotional distress, or even death, and can also adversely affect care providers, often referred to as the “second victim.” ObjectiveGiven the persistence of adverse events in the operating rooms, the objective of this study was to quantify the effect of an innovative and immersive virtual reality (VR)–based educational intervention on (1) safety behaviors of surgeons in the operating rooms and (2) sense-making regarding the overall training experience. MethodsThis mixed methods pre- versus postintervention pilot study was conducted in a large academic medical center with 55 operating rooms. Safety behaviors were observed and quantified using validated Teamwork Evaluation of Non-Technical Skills instrument during surgical cases at baseline (101 observations; 83 surgeons) and postimmersive VR based intervention (postintervention: 24 observations within each group; intervention group [with VR training; 10 surgeons] and control [no VR training; 10 surgeons]). VR intervention included a 45-minute immersive VR-based training incorporating a pre- and postdebriefing based on Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) principles to improve safety behaviors. A 2-tailed, 2-sample t ResultsPreintervention, all safety behaviors averaged slightly above “acceptable” scores, with an overall average of 2.2 (range 2‐2.3; 0‐3 scale). The 10 surgeons that underwent our intervention showed statistically significant (P ConclusionsVR-based immersive training intervention focused on TeamSTEPPS principles seems effective in improving safety behaviors in the operating rooms as quantified via observations using the Teamwork Evaluation of Non-Technical Skills instrument. Further research with larger, more diverse sample sizes is needed to confirm the generalizability of these findings.https://mededu.jmir.org/2025/1/e66186
spellingShingle Lukasz Mazur
Logan Butler
Cody Mitchell
Shaian Lashani
Shawna Buchanan
Christi Fenison
Karthik Adapa
Xianming Tan
Selina An
Jin Ra
Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study
JMIR Medical Education
title Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study
title_full Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study
title_fullStr Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study
title_full_unstemmed Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study
title_short Effect of Immersive Virtual Reality Teamwork Training on Safety Behaviors During Surgical Cases: Nonrandomized Intervention Versus Controlled Pilot Study
title_sort effect of immersive virtual reality teamwork training on safety behaviors during surgical cases nonrandomized intervention versus controlled pilot study
url https://mededu.jmir.org/2025/1/e66186
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