Precision Scoring Feature in VR

Problem To Solve

During the placement of an intramedullary nail to secure a patient’s hip fracture, orthopedic surgeons need to develop the skills to accurately place a guide pin which precedes the placement of the nail. if the guide pin is placed in the wrong location, the surgeon could make the fracture worse. By developing a feature in our virtual reality simulation that provides feedback for the placement of the guide pin, we are setting up current and future surgeons to succeed in accurately placing an intramedullary nail.

Tasks

Identify and Design:

  • Scoring system for guide pin placement

  • UI Screen Display and Copy for User Feedback In Virtual Reality

  • Additional Resources in VR that teach and help the surgeon about the ideal guide pin placement

Solution

Provide the user with the skillset to succeed in guide pin placement by allowing them to fail and repeat guide pin placement as many times as needed to learn the technique.

Target Audience

Medical Device Representatives and Surgeons Using Osso VR to Learn to Place an Intramedullary Nail

Programs Used

Adobe Illustrator, Boords.com

Role

UX Designer


The Design Process


Interviews

2 Subject Matter Experts were interviewed prior to designing the user feedback screen and scoring system for a guide pin placement in the intramedullary nail placement in a hip.

Interviewee #1: Residency Program Director in Orthopedic Surgery

The first interviewee was known for his expertise in residency programs as a program director. Interviewing him helped the team gain insight on specific teaching moments within the guide pin placement.

First page of the precision scoring storyboard used to communicate technique to residency program and product owner.

First page of the precision scoring storyboard used to communicate technique to residency program and product owner.

Interviewee #2: Trauma Orthopedic Surgeon

The second interviewee was an expert in trauma based intramedullary nailing and was able to give more of the specifics around the technique ensuring that as a team we were accurately portraying the medical technique and helping to concretely define the scoring system. Some of the questions posed were as follows:

  • How do surgeons know if the entry portal is placed correctly?

  • Where does the surgeon stand when inserting the entry portal?

  • At what point does a surgeon know that they need to adjust the reamer angle to finish reaming?

  • When watching a resident performing this technique, how much leeway is there in angle insertion, entry point, and depth of the guide pin for it to be a successful guide pin placement?

  • What is the most difficult aspect of this technique? What should a resident or surgeon be aware of as potential complications in this technique?

Both sources of expertise were hugely insightful in capturing both the anatomical accuracy of guide pin placement as well as identifying opportunities to teach current and future surgeons.

Defining Work Items and Scoring Values

Based on information collected from both subject matter experts and from the product owner, the team was able to define a list of work items to complete the feature. Furthermore, we were able to define how we wanted to score the user’s guide pin placement and begin to design the feedback screen and providing further resources.

The design and copy for the feedback screen followed a similar design as was previously crafted for a different technique. Previously, the screen recommendations were deemed effective and the copy was understandable by our target audience (surgeons) previously.

Feedback screen - The user receives feedback on how to improve their guide pin placement performance in the areas of the guide pin start point, angle, and depth. The checks and x marks on the right side emphasize which part of the placement the user failed on to receive a “Try Again” message. There is a retry button at the bottom of the screen that allows the user to remove the guide pin from the hip and try to place it again to receive a new score: “Try again” or “Pass”

Feedback screen - The user receives feedback on how to improve their guide pin placement performance in the areas of the guide pin start point, angle, and depth. The checks and x marks on the right side emphasize which part of the placement the user failed on to receive a “Try Again” message. There is a retry button at the bottom of the screen that allows the user to remove the guide pin from the hip and try to place it again to receive a new score: “Try again” or “Pass”

Extra Resources For Ideal Guide Pin Placement

To help surgeons learn the ideal guide pin placement, we placed a second screen above the live fluoroscopy image and showed what the ideal guide pin would look like in AP and lateral views. Furthermore, we provide a model of the femur with a shortened guide pin ideally inserted into the greater trochanteric portion of the femur.

Learnings

  • You don’t always need to recreate the wheel with your designs. If a design was put in place that works, then sometimes it’s beneficial to look at what works and improve that instead of starting from scratch

  • Communication between departments is crucial to determine what can and can’t be built in a given amount of time. Also, it just builds for stronger relationships which is key to produce beautiful, feasible, and timely work!