Validation of a new virtual reality software designed for regional anaesthesia by testing performance between novice and experienced participants

Virtual reality can be used as form of simulation-based medical training, replicating real-life scenarios in which participants can learn and rehearse new cognitive and motor skills. A new virtual reality software has been designed to teach needling skills relevant for anaesthetists performing ultrasound-guided regional anaesthesia. Prior to wider spread adoption of this training software, construct validation and comparison to existing metrics is warranted. This is a fully volunteer observational study of adults who consent to participate after full informed consent. Groups: 1) 15 novices (defined as no prior exposure to ultrasound, ultrasound-guided regional anaesthesia, or training in nerve blocks) will be recruited from attached medical schools and anaesthesia staff at Liverpool Hospital, Sydney 2) 15 experienced (defined as having previously performed >50 ultrasound-guided regional anaesthesia procedures) will be recruited from anaesthesia staff at Liverpool Hospital, Sydney All participants are de-identified Procedure: Both groups will receive a 10min video on ultrasound, ultrasound-guided needling, and basic transducer skills prior to use of virtual reality. This video is a composite of two publicly available YouTube educational videos from the Departments of Anaesthesia, University of California San Francisco, USA, and Queen Victoria Hospital, East Grinstead, UK Immediately after viewing the video, each participant will don the VR equipment and within the VR software, each will be asked to scan a region on the virtual patient and identify the nerve target. 4 locations (nerve targets 1 to 4) are selected for participants to attempt a needling task. Each participant will be asked to perform the needling task on each 4 nerve targets 10x each (for a total of 40 attempts). This virtual needling period will last for a maximum of 60 min, with a rest break of 10min at 30min offered to participants if necessary. The virtual reality software calculates a performance score for each attempt based on the time taken, number of withdrawals, and angulation of the needle relative to the transducer Baseline characteristics taken prior to virtual reality exposure 1) Demographics including age, sex, number of years computing gaming, including previous virtual reality gaming 2) Depression, Anxiety and Stress Scale-21 (DASS-21) 3) NASA-Task Load Index score (NASA-TLX) After training using the new virtual reality software, endpoints collected include: 1) Performance score generated by the software for each attempt 2) NASA-TLX 3) Witmer and Singer Presence Questionnaire 4) Individual learning curves plotted as performance score versus attempt number