Exploring the promise of virtual reality in enhancing anatomy education: a focus group study with medical students

Virtual reality (VR) has the potential to be used as a transformative tool in medical education - offering both interactive models and clinical simulations to enhance training. VR presents a space and cost-effective solution for remote education, combined with prospects of higher efficiency and interactivity than traditional training. This study aimed to explore the potential application and perception of VR in a focus group of medical students as an innovative tool for learning anatomy. Sixteen students underwent a structured VR lesson plan exploring concepts in anatomy. Pre- and post-surveys assessed participants’ exposure to VR, previous exposure to and preparedness in anatomy training, and attitudes toward VR. Results revealed that despite limited prior exposure to VR, participants found the technology both easy to navigate and comfortable to use. Notably, over 90% of students indicated that VR would enhance their anatomy learning experience and help them learn a topic better than traditional models. Furthermore, 94% of participants agreed that this learning modality should be offered to medical students, and if given access to this technology, most would utilize it for learning anatomy and potentially for other subjects as well. This study emphasizes VR’s potential to enhance medical education, particularly in anatomy instruction. VR’s adaptability, user-friendly interface, and positive student perceptions highlight its viability as a supplemental tool. Future research should explore specific anatomy applications, long-term impacts on knowledge retention, and the evolving role of VR in medical education

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Open Book Pelvic Fracture

History of present illness: A 31-year-old male was brought in by paramedics status post high-speed motorcycle collision. The patient was tachycardic and hypotensive with an initial Glascow coma scale (GCS) of 11. He required immediate blood transfusion and intubation. The patient had multiple traumatic injuries including a deformity to the left thigh and an unstable pelvis. He had palpable distal pulses, and grossly normal sensation and motor function to his bilateral lower extremities. Significant findings: The initial radiograph of the pelvis shows an open-book pelvic fracture deformity with pubic symphyseal dislocation, left greater than right sacroiliac diastases, and fractures of the left superior and inferior pubic rami, right inferior pubic ramus, and left acetabular anterior column. The additional inlet and outlet radiographs of the pelvis after application of a pelvic binder also show an open book fracture with significant improvement of the widened pubic symphysis. Discussion: Severe pelvic injuries, including open book dislocations, have a high mortality rate of 10.4%.1,2 The mechanism is commonly a motor vehicle collision or fall from a significant height.3 Open book dislocations of the pubic symphysis are rare, representing 0.3–8.2% of all fractures,4,5 and can lead to fatal complications through vascular, abdominal, and nervous injuries.6 In severe pelvic traumas, pelvic binders must be applied as soon as possible to reduce bleeding by realigning fracture surfaces and provide stabilization of unstable fractures.7,8 Open book dislocation can be identified via plain anteroposterior pelvis radiographs.9 Definitive treatment of open book dislocations are highly individualized and come secondary to controlling hemorrhagic bleeding. The most common method is open reduction and internal fixation (ORIF) although in some cases, external fixation can be sufficient to stabilize the pelvis.10 Our patient was admitted for multiple traumatic injuries and underwent closed reduction and percutaneous fixation of posterior pelvic ring, including bilateral sacroiliac joints, and ORIF of the pubic symphysis

Bilateral Hip Dislocation in Unrestrained Driver

History of present illness: A 24-year-old male was brought in by paramedics status post motor vehicle collision (MVC) into an electric pole and tree at high speed. The patient was an unrestrained driver who required extrication. The patient complained of left hip pain, left foot pain, and difficulty extending his bilateral lower extremities. He denied numbness or tingling to his lower extremities. The patient had normal vitals; his bilateral lower extremities were held in flexion at the hips, but otherwise had no obvious injuries. The patient’s pelvis was stable with palpable distal pulses and intact motor and sensory function of his distal lower extremities. Significant findings: The initial radiograph of the pelvis revealed bilateral hip dislocations. Small bony fragments were noted in the right hip joint, suggestive of an underlying fracture. The sacroiliac joints and the pelvic ring were intact. In the emergency department, bilateral hip reductions were performed using the Captain Morgan technique.1 The post-reduction film showed reduction of the bilateral hip dislocations with extensive comminuted and displaced fractures of the right and left acetabula. Discussion: Bilateral hip dislocations are extremely rare, occurring in only 1% of all hip dislocations,2 and require immense force, typically occurring in MVCs (74%).3-7 Associated injuries include fracture of the acetabulum or femoral head, sciatic nerve damage, and obstruction of the blood supply to the femoral head.8 X-ray imaging and CT scans are used to assess the injury and to detect intra-articular fragments.3 Definitive treatment is achieved by closed reduction if possible; otherwise open reduction is utilized.9 Post-reduction therapy includes a non-weight-bearing period of time. Complications include avascular necrosis of the femoral head, osteonecrosis, and posttraumatic arthritis, the occurrence of which can be decreased by early reduction.4,10-12 This patient underwent bilateral closed hip reductions in the ER in conjunction with orthopedic surgery and underwent operative management of his pelvic fractures at a later date

Open Book Pelvic Fracture

History of present illness: A 31-year-old male was brought in by paramedics status post high-speed motorcycle collision. The patient was tachycardic and hypotensive with an initial Glascow coma scale (GCS) of 11. He required immediate blood transfusion and intubation. The patient had multiple traumatic injuries including a deformity to the left thigh and an unstable pelvis. He had palpable distal pulses, and grossly normal sensation and motor function to his bilateral lower extremities. Significant findings: The initial radiograph of the pelvis shows an open-book pelvic fracture deformity with pubic symphyseal dislocation, left greater than right sacroiliac diastases, and fractures of the left superior and inferior pubic rami, right inferior pubic ramus, and left acetabular anterior column. The additional inlet and outlet radiographs of the pelvis after application of a pelvic binder also show an open book fracture with significant improvement of the widened pubic symphysis. Discussion: Severe pelvic injuries, including open book dislocations, have a high mortality rate of 10.4%.1,2 The mechanism is commonly a motor vehicle collision or fall from a significant height.3 Open book dislocations of the pubic symphysis are rare, representing 0.3–8.2% of all fractures,4,5 and can lead to fatal complications through vascular, abdominal, and nervous injuries.6 In severe pelvic traumas, pelvic binders must be applied as soon as possible to reduce bleeding by realigning fracture surfaces and provide stabilization of unstable fractures.7,8 Open book dislocation can be identified via plain anteroposterior pelvis radiographs.9 Definitive treatment of open book dislocations are highly individualized and come secondary to controlling hemorrhagic bleeding. The most common method is open reduction and internal fixation (ORIF) although in some cases, external fixation can be sufficient to stabilize the pelvis.10 Our patient was admitted for multiple traumatic injuries and underwent closed reduction and percutaneous fixation of posterior pelvic ring, including bilateral sacroiliac joints, and ORIF of the pubic symphysis