Researcher of the month: Mads Emil will strengthen surgical treatment of bone fractures with new VR simulator

by | Dec 6, 2022 | All

Mads Emil is not joking when he says that as a PhD student he has chosen bone fractures as a research area. With 30,000 surgical procedures each year, there is a huge need in the Danish healthcare system for training and skills development of orthopaedic surgeons to treat bone fractures.

In the VR BOSS (Virtual Reality Basic Osteosynthesis Surgery Simulation) project, he is developing and implementing a VR simulator for training and competence assessment in surgical treatment of bone fractures.
But what is the potential, the drive and the ambition? And how will it ultimately benefit patients?
We asked Mads Emil.

What is the core of your PhD project?
The essence is a completely new approach to the development of simulation for technical surgical education.

In 2019, part of my supervisory group published a needs assessment that determined that basic fracture surgery was the area of orthopaedic surgery in which simulation-based training should be offered as a top priority.

As there was no simulator for the purpose, we started developing our own virtual reality simulator from scratch. Based on recommendations from experts with the most experience in training in the field, we are developing the simulator to meet the greatest training need.

We believe that this innovative systematic and transparent approach to simulator development can create great value for both patients and healthcare. I therefore hope that it will become the standard for future simulator development.

Who are you working with on the project?
We have a partnership with the global orthopaedic surgery organisation AO Foundation, through which we have engaged orthopaedic surgery experts from across 44 countries to define the assessment parameters that are most important for a wide range of procedures that the simulator will include.

The experts, who all have extensive experience in training surgeons, have collectively spent hundreds of hours reaching consensus and defining the individual assessment parameters.

These parameters enable automated feedback on the simulator, so that after the procedure the user is given very concrete targets on how to improve.

Why are you doing research in the CAMES framework?
I am employed at the Department of Orthopaedic Surgery at Slagelse Hospital, and the project is thus a close collaboration between my clinical place of employment and CAMES. I was hired as a student assistant at CEKU in 2012 and helped to start up the simulation centre.

At that time we had only a few rooms on the first floor of the Teilum building and did not offer many courses. CEKU later became CAMES, and in that sense I have been there from the beginning. I have seen the centre grow and how much it has helped to improve the quality of medical education - for the benefit of patients.

What is the potential - nationally and internationally ?
We will work to ensure that the fully developed and validated virtual reality simulator - within a foreseeable timeframe - is integrated as a central part of the training for orthopaedic surgeons in Denmark.

The format of so-called full immersion virtual reality makes the purchase significantly cheaper than similar high fidelity simulators, as the required equipment is easily available and quite affordable. It allows flexible organisation of training to ensure that it takes place when you are on the cusp of having to operate. Neither before nor after.

With an estimated 178 million fractures a year worldwide, and an ageing population, easily accessible training like this could make a significant difference. Although far from everyone with a fracture needs surgery, even minimal improvements in complication rates, as a result of easily accessible and evidence-based education with automatic feedback, could have a major impact on a very large number of patients.

What is the potential - nationally and internationally?
My hope is that the tools will also be used internationally both for teaching purposes, but just as importantly in medical education research. Precisely so that research results can be compared across both regions and countries.

Our vision is that the results can form the basis of international consensus on when an ultrasound operator is competent and hopefully contribute to the assessment of which training methods ensure optimal training in MSK-UL.

As with all researchers working in medical education, the overall ambition is to reduce inequalities in the care you receive - regardless of where you are in the country and which doctor you are seen by.


Check out the VR simulator in use

The VR BOSS project (Virtual Reality Basic Osteosynthesis Surgery Simulation) is an excellent example of how we at CAMES always work in an application-oriented way with our research. Mads Emil Jacobsen is working on his PhD to develop and implement a VR simulator for education, training and competence assessment in surgical treatment of bone fractures. Here you can see how the VR simulator works when surgeons are training in fracture surgery.