DOI

https://doi.org/10.25772/8Q9S-9833

Author ORCID Identifier

https://orcid.org/0000-0002-1091-8144

Defense Date

2025

Document Type

Thesis

Degree Name

Doctor of Philosophy

Department

Pharmaceutical Sciences

First Advisor

Dayanjan S. Wijesinghe

Abstract

Extended‑reality (XR) technologies including virtual reality (VR) and mixed reality (MR) offer new ways to improve training and surgical precision. This thesis evaluates their educational and clinical impact through two complementary studies.

Specific Aim 1 compared an immersive 360° video VR module with conventional training for teaching USP < 797> sterile‑compounding skills to second‑year PharmD students (N = 36). VR trainees raised their knowledge from 6.14 ± 1.55 to 8.69 ± 1.07, yet the overall post‑test advantage versus control was not statistically significant (U = 71.50, p = 0.21). Item‑level McNemar testing showed significant VR‑exclusive gains on three critical questions (K5, K6, K10; p ≤ 0.004). Self‑perceived confidence (U = 130.00, p = 0.284) and rubric‑based performance (U = 136.00, p = 0.41) were comparable between groups. NASA‑TLX scores confirmed the intervention was well‑tolerated, with high perceived performance (mean = 90) and very low frustration (mean = 7.5).

Specific Aim 2 employed a randomized crossover design in which three PGY‑4 orthopedic residents placed guide‑wires in 3D‑printed scapulae under free‑hand and MR‑guided conditions, yielding 15 paired observations. MR guidance (Microsoft HoloLens 2 plus custom planning software) reduced positional error from 22.46 ± 14.38 mm to 12.23 ± 8.98 mm (t = 2.34, p = 0.027), while rotational and overall Euclidean errors showed non‑significant but favorable trends. Descriptive NASA‑TLX data suggested lower mental and physical demand with MR support.

Conclusions. VR delivered item‑specific sterile‑compounding knowledge gains. MR significantly improved positional accuracy in simulated shoulder arthroplasty. Together these findings demonstrate that XR can both enrich learning and improve precision, underscoring its promise for widespread adoption in pharmacy education and surgical practice.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

5-8-2025

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