Virtual reality tracheostomy training to reduce the carbon footprint of medical education

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The UK **National Tracheostomy Safety Project** (NTSP Ltd, www.tracheostomy.org.uk) is a charitable company established in 2014 to improve care through education. Tracheostomies are artificial tubes inserted into the necks of around 20,000 patients in the UK each year to help recovery from critical illness or surgery. These complex patients cared for in our complex healthcare system can sometimes come to harm.Through fund raising, running courses and grant funding, the NTSP developed educational resources and quality improvement strategies to improve tracheostomy care. Our work has been adopted nationally (NHS England National Patient Safety Improvement Program 2020) and globally (Global Tracheostomy Collaborative, www.globaltrach.org) and has improved the quality and safety of care delivered in hospitals and communities in the NHS and beyond.In one study, published in 2020, we trained over 4,000 staff in 20 NHS hospitals, predominately with face-to-face courses. We demonstrated a 50% reduction in harm; 50% reduction in anxiety and depression amongst vulnerable patients; and a 20% reduction in hospital length-of-stay (see https://my.visme.co//index.php?\_url=/view/y4j11r6z-itc-headline-results&).However, the challenge of continually training new/rotating staff throughout the NHS is huge. The NHS's carbon footprint is **around 20 million tonnes of carbon dioxide each year.** The advent of high-quality, affordable virtual and augmented reality headsets offers a unique opportunity to revolutionise the delivery of tracheostomy education and significantly reduce spending and travel to our centralised courses. We can still deliver expert content, but deliver it locally, with high-quality, immersive content. Tracheostomy care is not the only area that can benefit from VR technology, but is unique in encompassing the full multidisciplinary team (doctors, nurses, physiotherapists, speech and language therapists) from many different specialties (adult/paediatric, ENT, Maxillofacial, Anaesthesia and ICU). Importantly, NTSP partners closely with patients, families and carers, developing training and resources that can speed up hospital discharges and improve care in the community.**Key objectives:*** develop **virtual reality tracheostomy training courses** for NHS staff* develop **virtual tracheostomy training** for parents, families and carers* deliver courses locally (base hospitals or even at home)* evaluate the impact of training and reduced travel**Our vision:**1. _Eliminate avoidable harm during tracheostomy care through education_2. _Reduce the carbon footprint of face-to-face centralised_ _training by providing local virtual-reality courses_**Our focus:**Achieving **net zero healthcare** through applying new virtual reality education by national experts, locally. Through robust demonstration of proof-of-concept, our innovative idea is affordable, adoptable and investable, opening up this strategy for wider medical education and commercialisation.