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

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. CLINICALTRIAL None INTERNATIONAL REGISTERED REPORT RR2-10.2196/40445.