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At the start of the procedure, the first thing Dr. Komal Bajaj has to get past is a thick band of nose hairs.

She gently maneuvers the endoscope through the nasal passage, trying to open up the patient’s airway. A slight blunder with her handling causes a blob of mucus to stick to the side of the camera attached to the endoscope, obstructing her vision.

The patient’s heartbeat picks up, the breathing intensifies. Bajaj accidentally touches the vocal chords with the endoscope, which causes the patient to cough – and it’s game over.

But luckily, it really was just a game: the entire procedure took place on a virtual reality app called Airway Ex, which gamifies surgery to help train medical professionals.

Bajaj is a reproductive geneticist and the Clinical Director at the NYC Health and Hospital Simulation Center. She is tasked with thinking of new ways to use technology to train more than 40,000 medical professionals in New York City.

Airway Ex is one of those technologies and it lets medical professionals practice minimally invasive surgeries on a virtual patient’s airway, all from their smartphones or tablets. The app uses video game technology to teach surgeons how to expertly handle an endoscope to keep a patient’s airway clear, giving them realistic scenarios like dealing with tonsillitis and inflammation. Changes in tissue behavior, breathing fluctuations, bleeding, and realistic fluids and secretions appear as the game progresses.

A bird’s eye view of a virtual patient’s nose before the surgeon begins the endoscopic procedure.
A bird’s eye view of a virtual patient’s nose before the surgeon begins the endoscopic procedure. - 

“With an app like this you can see your success incrementally and people are incentivized to complete a case to the best of their ability,” Bajaj said. “There’s a pride in their work, and an element of feedback that you might not get on a ward.”

The need for realistic training is important, Bajaj said. It’s the basis for the design of the NYC Health and Hospitals Simulation Center, a building that houses several different rooms that replicate those you would see in a real hospital.

Operating rooms, E.R. bays and birthing suites are all available for doctors to practice procedures in a realistic setting. The equipment is real, the sounds are real, and even the patient mannequins are pretty near the real thing. They can blink, breathe, moan and groan if required, and if the doctor working on them isn’t good enough, they “die.”

Similar to the dummies in the simulation center, the patient on the app screen reacts to the surgeons’ movements.

“Traditional medicine needs help. Health care education is really far behind and current training for doctors is too long and expensive,” Bajaj said.

The app provides credit for Continuing Medical Education, or CMEs, which some states require medical professionals to complete on a regular basis to keep updated in their fields.  Bajaj said the app can allow practitioners who need this specific training to earn the credit at their desk, and on the app, saving both time and money.

Surgeons play to receive the coveted three hearts, a symbol that lets them know they are fully able to handle that situation if it happens in real life. 

You can get the app on Google Play and iTunes. 

Correction (Jan. 4, 2016): A previous version of this story stated that the app provided accreditation for Continuing Medical Education, instead of credit for CME.

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