15. Utilization of Augmented Reality Smart Glasses for the Provision of Remote Surgical Training in the Resource-Constrained Setting

Abstract

Background: Surgical mission trips constitute an important strategy by which the global surgery campaign addresses inequities in surgical disease worldwide. Travel restrictions related to the COVID-19 pandemic, however, impose a challenging limit on the reach and impact of surgical mission work. In this study, we demonstrate the utility of a remote surgical mentorship program equipped with cutting-edge augmented reality (AR) technology for sustaining global surgery capacity building efforts within the constraints of the COVID-19 pandemic. Methods: Our remote surgical training program connects mentor and mentee surgeons via an AR-enabled digital headset and integrated smartphone application. The Vuzix® Smart Glasses system allows mentee surgeons to transmit a point-of-view livestream of activity in the operating room while receiving direct audio and visual feedback from their remote mentor in realtime. To facilitate their engagement, mentor and mentee surgeons interact using an integrated smartphone application that enables case scheduling, clinical documentation, and performance evaluation. Performance is assessed on the basis of three validated assessment tools that are well-established in the surgical education literature: the Objective Structured Assessment of Technical Skills, the Self-Confidence Scale, and the Student Evaluation of Educational Quality Survey. This survey is administered via the mobile application to both mentor and mentee surgeons at the time of their onboarding as well as after every subsequent three-month training quarter for the duration of the year-long program. Results: To date, 83 mentor and mentee surgeons across 33 countries and 6 continents are enrolled and actively participating in our remote training program. Baseline survey data suggest a mentee surgeon cohort that stands to benefit greatly from inclusion in our training program. A majority of mentee surgeons report incomplete knowledge and anxiety in association with their specialty prior to initiating training. Conclusion: The COVID-19 pandemic has created an urgent need for sustainable remote surgical capacity building strategies. Our remote surgical training program powered by AR-enabled telecommunication and smartphone technology constitutes a promising solution towards this end.