IMPROVING COMPETENCY THROUGH IMMERSIVE EXPERIENCES: The evaluation of an immersive virtual reality module as a teaching tool for CT-guided liver biopsies within the field of radiology

Abstract

The acquisition of procedural skills in medical training remains an ongoing challenge. Within radiology, where procedural mastery is a key milestone, virtual reality (VR) presents a potential solution. This study evaluated the effectiveness of a novel, VR CT-guided liver biopsy module in improving residents’ knowledge and confidence. A quasi-experimental pre-post study was conducted at Massachusetts General Brigham, Brigham and Women’s Hospital, and Duke University Hospital. Residents were divided into a control group (PGY-1) and an intervention group (PGY-2 and PGY-3). Both groups completed pre- and post-surveys and a final-survey one month later. The intervention group completed the VR module between the pre- and post-surveys and then before the final-survey. Surveys assessed: (1) knowledge and cognitive skills, (2) confidence, and (3) learning experience. Exam scores from the knowledge section were analyzed with a Wilcoxon signed-rank test as was confidence measured using Likert-scale questions. VR headset data recorded performance metrics. The intervention group demonstrated a significant increase in knowledge from pre- to post-survey (p = 0.03) with no significant change at follow-up (p = 0.09). Confidence in ordering procedural steps and performing the procedure increased significantly from pre- to post-survey (p = 0.03 and p = 0.02 respectfully) and from pre- to final-survey (p = 0.01 and p = 0.01). Confidence for identifying instruments did not significantly improve from pre- to post- (p = 0.09) or from pre- to final- (p = 0.01). VR headset data showed a significant increase in time to complete the module one month later (p = 0.03), suggesting a decline in VR-specific technical skills, though the number of scans to place the coaxial needle and needle placement accuracy remained stable, indicating retention of procedural knowledge. The VR module effectively improved residents’ knowledge and confidence with CT-guided liver biopsies, demonstrating its value as a teaching tool. Despite usability challenges with the headset and controllers, participants found the VR module valuable, and the majority reported they learned something new. This work highlights the clear value of integrating VR into the training of interventional radiology residents. Future studies can correlate VR module usage with clinical performance and patient outcomes.