P1: THE VITAL STUDY: A FEASIBILITY STUDY OF A RANDOMISED CONTROLLED TRIAL TO EXAMINE IF VIRTUAL REALITY TECHNOLOGY CAN IMPROVE SURGICAL TRAINING IN SIERRA LEONE

Training surgeons is expensive and relies on expert supervision. Virtual reality (VR) may enhance acquisition of knowledge and skills. There is limited evidence on the effectiveness of VR in low and middle-income countries (LMICs). The purpose of this study was to evaluate the technical feasibility of mobile phone VR in LMICs and the feasibility of conducting a full-scale randomised controlled trial. Method A prospective randomised controlled feasibility study was conducted. Surgical trainees were recruited from a government teaching hospital in Freetown in November 2019. Participants were randomised 1:1 VR vs non-VR. These were given one-week prior to a two-day hands-on course on lower limb amputation. The VR training involved two 30-minute modules consisting of narrated live surgery videos. Feasibility outcomes included recruitment rates and VR intervention fidelity and acceptability. Result Thirty participants were randomised to the VR group (n=15) or control group (n=15). Of these, 29 (96.7%) participants completed the course. The recruitment period required was two days. Intervention adherence exceeded defined success rates with 100% of participants completing the intervention. There was no unblinding. Compared to controls, the VR group rated statistically significantly higher engagement during the course in 4/6 domains, increased perceived learning in 5/5 domains and increased engagement with pre-course learning in in 4/6 domains. Conclusion VR is technically feasible in an LMIC setting and improves engagement and perceived learning. With minor modifications to the intervention and assessments, a full-scale trial is feasible. Further exploration is required to determine the best outcome measures to demonstrate effect. Take-home message VR is technically feasible in an LMIC setting and improves engagement and perceived learning. Now we need to explore if it can improve surgical knowledge and skill acquisition on a large scale.