title: A Virtual Reality Simulation Model of Spinal Ultrasound: Role in Teaching Spinal Sonoanatomy.
abstract: OBJECTIVE
  Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model (http://www.usra.ca/vspine.php and http://pie.med.utoronto.ca/vspine). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy.
  
  
  METHODS
  After obtaining ethics board approval and written participant consent, 14 anesthesia trainees with no prior experience with spine ultrasound imaging were included in this study. Construct validity was assessed using a pretest/posttest design to measure the knowledge acquired from self-study of the virtual spine simulation modules. Two tests (A and B) with 20 multiple-choice questions were used either for the pretest or posttest, at random in order to account for possible differences in difficulty between the 2 tests. These tests were administered immediately before and after a 1-hour training session using the spine ultrasound model.
  
  
  RESULTS
  Fourteen anesthesia trainees completed the study. Seven used test A as the pretest (group A), and 7 used test B as the pretest (group B). Both groups showed a statistically significant improvement (P < 0.05) in test scores after a 1-hour session with the spine ultrasound model. The mean scores were 55% (SD, 11.2%) on the pretest and 77% (SD, 8.7%) on the posttest.
  
  
  CONCLUSIONS
  The study demonstrated that after 1 hour of self-study by the trainees on the spine ultrasound model test scores improved by 40%.
authors.affiliation: From the *Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa; and †Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Reva
authors.initials: R
authors.lastname: Ramlogan
authors.forename: Ahtsham U
authors.initials: AU
authors.lastname: Niazi
authors.forename: Rongyu
authors.initials: R
authors.lastname: Jin
authors.forename: James
authors.initials: J
authors.lastname: Johnson
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Chan
authors.forename: Anahi
authors.initials: A
authors.lastname: Perlas
mesh_terms: D000715:Anatomy / Q000193:education*; D000776:Anesthesiology / Q000193:education*; D003196:Computer Graphics; D003194:Computer-Assisted Instruction / Q000379:methods*; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D004522:Educational Status; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D017145:Models, Educational; D014463:Ultrasonography; D000076142:Virtual Reality