Haptic feedback during virtual reality training significantly improves First-Year orthopedic resident performance at tibia drilling: a randomized trial

Background: Few studies have investigated whether haptic feedback improves the effectiveness of virtual reality (VR) simulation. This study aimed to determine whether new orthopedic surgery residents trained on haptic feedback-enabled VR performed basic drilling better than residents who had trained on VR without haptic feedback. Methods: Fourteen first-year orthopedic surgery residents were enrolled and randomized into “haptic” or “non-haptic” groups and blinded to study goals and randomization. Residents participated in a VR tibia drilling simulation with haptic feedback either turned on or off and then performed a plastic resin tibia model drilling session where overdrill depth was measured by two raters blinded to study groups. Questionnaires were completed before and after the hands-on sessions with responses on a five-point Likert scale. Results: There were no significant differences in demographics between groups. Overdrill depth during the first trial was significantly less in the haptic group than the non-haptic group (3.9 mm vs. 6.0 mm, P=0.005). Subsequent trials showed no significant difference in mean overdrill depth between groups (P>0.05). Haptic group participants reported higher confidence in the safe use of surgical tools (4 vs. 3, P<0.01) and more simulation realism (4 vs. 3, P<0.01). Conclusion: VR training with haptic feedback significantly improves initial performance during use of a surgical drill through a tibia model compared to VR training without haptic feedback in first year orthopedic residents. The addition of haptic feedback also increases the perceived value, realism, and enjoyment of VR simulation. Level of Evidence: Level II.