Abstract 4364013: Virtual Reality Curriculum Improves Pediatric Cardiology Fellow Understanding of Hypoplastic Left Heart Syndrome Palliation: A Multi-Center Study of the Michigan Anatomic Congenital Heart in 3D (MACH-3)

Background: Fellowship training in pediatric cardiology requires complex three-dimensional visuospatial reasoning. Previous work has shown that virtual reality (VR) curricula can improve basic understanding of congenital heart disease. The efficacy of using VR to teach more complex cardiac anatomy and physiology, such as hypoplastic left heart syndrome (HLHS) and single ventricle surgical palliation, is unknown. Hypothesis: Pediatric cardiology fellows who complete a VR learning module on the various stages of HLHS surgical palliation will demonstrate superior understanding of the underlying anatomy and pathophysiology as compared to fellows who do not. Methods: Thirteen pediatric cardiology fellowship programs at major congenital heart centers were recruited to this study, with first-year fellows as the participants. Programs were assigned to the control group or intervention group. Fellows in the intervention group completed the Michigan Anatomic Congenital Heart in 3D (MACH-3) curriculum, which was not available to the control group. Both groups then completed a validated assessment tool. The total assessment score was calculated by summing the number of questions that participants answered correctly, ranging from 0 to 29. The difference in total assessment scores between the groups was examined using two-sample t-test and Cohen’s d effect size. Results: A total of 56 fellows were included in the analysis. Participants in the intervention group achieved higher total assessment scores (n=24, 23.8 ± 3.1 questions correct out of 29) than those in the control group (n=32, 21.8 ± 3.9 questions correct) (p=0.04), with a moderate effect size of 0.56. Most participants in the intervention group reported via survey that the curriculum was easy to use (96%) and enjoyable (92%), found the experience to be effective in improving their knowledge base (100%), and would recommend that this or some other VR teaching tool be incorporated into pediatric cardiology fellowship training (96%). Conclusions: In a multi-center educational study, a VR curriculum was shown to improve pediatric cardiology fellow knowledge of HLHS anatomy, pathophysiology, and palliation, while receiving nearly universally positive feedback from participants. Potential future directions for this research include expansion to include other complex congenital cardiac lesions or investigation of formalized incorporation of VR modalities into fellowship curricula.