The Client & Concept

Alder Hey Children’s NHS Foundation Trust is one of the UK’s leading children’s hospitals, alongside being globally ranked. Every year, they provide care for over 450,000 children and young people. This innovative hospital has been ranked in the Top 20 of specialised paediatric hospitals in the world by Newsweek.

The Clinical Director of ENT & Audiology at Alder Hey Children’s Hospital, Mr Sunil Sharma had previously collaborated with ExR to develop immersive training experiences for head and neck trauma. Based on the engagement with the previous training series, there was further interest to create more, however this time it would incorporate real-patient experiences as an opportunity to widen access to a single training experience.  

The Brief 

The ambition of this VR (virtual reality) experience was to curate medical training for mastoid surgery and endoscopic tympanoplasty, that would be widely accessible and cost-efficient. 

According to the Foundation Trust Network, the estimated total yearly expenditure on surgery in NHS England amounts to £4.5 billion, with individual theatres costing on average £1.5 million a year to run. Their benchmarking study estimates that the cost of each theatre hour is on average £561 (65% of which is staff cost). 

As operating theatres are one of the most expensive clinical activities, the hospital needed an alternative that would maintain the engagement level of watching a real-life surgery, but without the associated costs. To add to this, a theatre room has a limited capacity, only enabling a few students/trainees to observe a training surgery at a time. VR revolutionises the traditional training approach, empowering hospitals with an immersive training format that is infinitely scalable. 

Accelerating ENT Training 

For this project, 360-degree filming of a real patient procedures was chosen as the optimal format to deliver the brief. 

To curate these training films, we leverage collaborator expertise from a medical procedure perspective and combine this with our filming capability to build VR scenarios that perfectly reflect real-life situations. Co-ordinating with the hospital team, we agreed on a date to film, and from there organised all the required equipment and paperwork to proceed on the day. 

Co-creation is the foundation of the ExR solution. To deliver on this project’s demands, we brought together the theatre and comms teams, which were overseen by Sunil Sharma. We drafted a co-creation agreement that was tailored to their needs, alongside consent forms for both the patients and staff that were involved. 

A lightweight one-person crew was utilised to film on the day, who applied two cinema cameras operated remotely using a robot, plus 360-degree cameras and microphones. Aside from this, we accessed the visual feeds from the endoscope and microscope also. 

After the filming concluded in just one shoot, our team edited the footage, and applied a voiceover created by Sunil to describe key training steps. The final draft was then returned to the clinical team in a rapid timeframe. The footage was meticulously checked by Sunil who supplied live edits to ensure the anonymity of the patient, alongside ensuring the material maximised the educational outcomes. Once the films had been approved by the team, it was placed live on the ExR platform.

Widening Access to Medical VR Training 

As a result of the filming, there was two lessons created, one for mastoid exploration and one for endoscopic tympanoplasty. The tympanoplasty is a short procedure encapsulated in one video. The mastoid exploration was broken down into four videos: the huddle and team brief, mastoid access, mastoid dissection and mastoid reconstruction. 

Not only did VR maximise the training processes of Alder Hey Children’s Hospital, but its quality level and interactive format means it can even count towards clinicians’ CPD (Continuing Professional Development) training, as a recognised learning activity awarded by the Royal College of Surgeons. These readily available immersive simulations will help to expand knowledge amongst clinicians and support them in building the required technical competencies to deliver this surgery.

The series will be available in the hospital’s training curriculum to be distributed amongst all those who need access to it. It won’t just be available to just those medical professionals based at Alder Hey Children’s Hospital either, it will be accessible to all. Aligning with our value to democratise access to healthcare VR in the NHS, this film will be uploaded to the ExR platform where it will be free to access for all NHS users. 

VR has the possibility to address the pressing resource restraints that exist in the NHS whilst simultaneously delivering transformative learning at scale. Join us at the forefront of medical education and create your own immersive VR training.