Gaming meets medicine to become a Nova Scotia neurosurgeon's essential tool

A crossover between the worlds of gaming and medicine has the potential to cut training time in operating rooms by half and dramatically change the way surgical teams operate in the future, according to the head of neurosurgery in Nova Scotia.

Dr. David Clarke, who works with Dalhousie University and the Nova Scotia Health Authority, is leading the charge to make virtual reality a regular aspect of the job for hospital staff.

"At some point in the not-too-distant future, a patient will legitimately ask, 'Why are you teaching that in the operating room on me as a patient? You should be teaching that in a simulated environment.'"

Clarke has a virtual reality program set up in his office that allows doctors and nurses to practise the motions of a surgery before they walk into the operation room.

The program, made by Surrey, B.C., developer Conquer Experience, is called PeriopSim. It uses videos of real brain surgeries that have been recorded in Halifax and tests the employees as they choose the right equipment for each step of the complicated procedures.

"I think this is tremendously exciting," said Clarke. "It really is a major shift in terms of how we fundamentally train people." 

Training aid

Often before a major surgery, Clarke and his team go into an empty operating room and rehearse what's to come. But rehearsals are time consuming, difficult to arrange and use valuable time in already busy operating rooms.

With virtual reality, Clarke's team can review the entire surgery in an office without their peers present.

"We estimate that half of all training that goes on in the operating room could be done in a simulated environment," he said.

That represents "tremendous opportunities" for a training hospital where the next generation of surgeons and nurses are learning skills, Clarke said.

Another hurdle medical teams face in specialized fields such as neurosurgery is the frequency with which they treat rare conditions. There may be large gaps between unique procedures, so by recording the surgeries and training with virtual reality, new staff such as residents can be trained faster, he said.

Ultimately, Clarke believes virtual reality will make it safer for patients.

Rehearsing 'an orchestra'

The idea the technology will make it cheaper for hospitals and safer for patients might seem like an ambitious goal, but Jen Hoyt, a nurse in the neurosurgery department, is convinced that is not an overstatement.

"No question. It's a fantastic tool," she said.

"We have nine neurosurgeons. Each surgeon has their own specific likes and dislikes. It's like an orchestra, a well-tuned instrument that just runs very smoothly. You need to have well-prepared people and they have to know what they're doing."

While Nova Scotia was one of the innovators in the development of PeriopSim, variations of the program are now used in 200 hospitals in North America. 

"It's like using all our video game skills, but having a real impact," said Angela Robert, CEO of Conquer Experience.

She said the medical world is just seeing the "tip of the iceberg" of how simulation can help the field. 

Building confidence

The Nova Scotia team is giving constant feedback to help with updates and filming surgeries to create a library.

Clarke is also conducting a study that includes 100 nurses who are using virtual reality before entering the operating room.

"This you can take out of the OR, train outside of the OR, [and] they're ready to go in. And when they see it they're not frightened, not afraid, they're used to it. They've seen it before, they can use their hands, they can get in."

Even though the program is still in development, Hoyt wants to move faster. She says they need to evolve as fast as the gaming world.