With over 190,000 marketed medical devices and a “dozen new or modified devices” being approved every day (Weiss and Mohr 2018), the pace of advancements in medical device innovation reinforces the dependent relationship Surgeons have with Surgical Device Representatives (SDRs). The American Medical Association, American College of Surgeons, and the Association for PeriOperative Registered Nurses all acknowledge the critical role SDRs have in the safe delivery of patient care, but are clear that the presence of the SDR in the operating room does not negate the need for the Surgeon and/or the Surgical team to receive training and be able to demonstrate competency in the application of the surgical device or technology, prior to the procedure (“AORN Position Statement on the Role of the Health Care Industry Representative in Perioperative and Invasive Procedure Settings” 2014; Association AM, n.d.; Surgeons ACo 2016). Consequently, there is a considerable emphasis on the technical competence of the SDR, in order to be able to successfully transfer the necessary knowledge and skills to the Surgeon and Surgical team (Bedard 2021), in a manner that is timely, comprehensive, and does not create additional burden to the staff or work environment. As the pace of surgical innovation increases, focusing on the optimization of training for SDRs will positively impact patient care by accelerating the safe use of surgical devices and technologies.
Current SDR training practices for new devices vary by company but typically are provided as in-service training with a mix of didactic and hands-on learning using simulators, including synthetic models and/or cadaveric laboratories. A return demonstration of competence may also be required for training completion. Producing, using, and maintaining training resources can be costly expenditures with variable levels of published evidence supporting the obtainment of the intended skill acquisition and retention (Nousiainen et al. 2016; Zendejas et al. 2013). Recently, Immersive Virtual Reality (IVR) has demonstrated itself to be a disruptive technology for surgical education, due to its improved learning efficiency and ability to quantitatively measure learning outcomes, in both technical and cognitive skill domains for surgical trainees (Lohre, Bois, Pollock, et al. 2020; Lohre, Morrey, and Goel 2020; Lohre, Wang, et al. 2020; Lohre et al. 2021a; Mao et al. 2021). Current offerings have been developed to leverage the interactive and realistic experience of IVR, maximizing evidence-based cognitive and behavioral-science learning concepts. These include concepts of deliberate practice, productive failure, and experiential learning cycles that replicate real-world training while mitigating the potential for patient harm.
As an emerging technology, researchers are yet to evaluate SDR’s perception of the suitability for using IVR for new device training. The primary objective of this study therefore is to determine how inclusion of IVR in annual training is received by SDR’s, and to examine learning efficiency through the application of virtual performance metrics.