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Surgical Innovation

Intelligent Virtual Operating Room for Enhancing Nontechnical Skills

To identify the key insights or developments described in this article

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JAMA Surgery

Published Online: March 15, 2023

Surgical Innovation

Article Information and Disclosures

Suvranu De, PhD¹;

Cullen D. Jackson, PhD²;

Daniel B. Jones, MD, MS³

Author Affiliations

¹FAMU-FSU College of Engineering, Tallahassee, Florida
²Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
³Department of Surgery, Rutgers New Jersey Medical School, Newark

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The operating room (OR) is a dynamic environment where surgeons, nurses, anesthesia providers, and technicians must work effectively as a team to provide optimal patient care. The success of surgery depends significantly on nontechnical skills: vigilance, leadership, decision-making, communication, teamwork, and conflict resolution.¹ The American College of Surgeons closed claims study found that failure to communicate was pervasive and accounted for 22% of the preventable complications.²

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Article Information

Corresponding Author: Cullen D. Jackson, PhD, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Yamins 2, Boston, MA 02215 (cdjackso@bidmc.harvard.edu).

Published Online: March 15, 2023. doi:10.1001/jamasurg.2022.6721

Conflict of Interest Disclosures: Dr De reported grants from the National Institutes of Health during the conduct of the study. Dr Jackson reported grants from the National Institute of Biomedical Imaging and Bioengineering during the conduct of the study and grants from CRICO Risk Management Foundation and the National Cancer Institute outside the submitted work. No other disclosures were reported.

Funding/Support: Research reported in this publication was supported in part by the National Institute of Biomedical Imaging and Bioengineering (grants 2R01EB005807-05A1 and 2R01EB005807-09A1).

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References

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Griffen FD , Stephens LS , Alexander JB , et al. Violations of behavioral practices revealed in closed claims reviews. Ann Surg. 2008;248(3):468-474. doi:10.1097/SLA.0b013e318185e196 PubMed Google Scholar Crossref

Truong H , Qi D , Ryason A , et al. Does your team know how to respond safely to an operating room fire? outcomes of a virtual reality, AI-enhanced simulation training. Surg Endosc. 2022;36(5):3059-3067. doi:10.1007/s00464-021-08602-y PubMed Google Scholar Crossref

Qi D , Ryason A , Milef N , et al. Virtual reality operating room with AI guidance: design and validation of a fire scenario. Surg Endosc. 2021;35(2):779-786. doi:10.1007/s00464-020-07447-1 PubMed Google Scholar Crossref

Hull L , Arora S , Stefanidis D , Sevdalis N . Facilitating the implementation of the American College of Surgeons/Association of Program Directors in Surgery phase III skills curriculum: training faculty in the assessment of team skills. Am J Surg. 2015;210(5):933-41.e2. doi:10.1016/j.amjsurg.2015.01.022 PubMed Google Scholar Crossref

Korndorffer JR Jr , Arora S , Sevdalis N , Paige J , McClusky DA III , Stefanidis D ; PEGASUS Research Group. The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: adoption rate, challenges and strategies for effective implementation into surgical residency programs. Surgery. 2013;154(1):13-20. doi:10.1016/j.surg.2013.04.061 PubMed Google Scholar Crossref

Milef N , Ryason A , Qi D , Alfred SO , Jackson CD , De S . Disruptions to shared mental models from poor quality of service in collaborative virtual environments. Sci Rep. 2021;11(1):23556. doi:10.1038/s41598-021-02567-7 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.