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Precision OS partnership brings advanced fracture care to under-served communities worldwide

Article Summary

April 16, 2020

In This Article:

Sign Nail Education PrecisionOS Partnership

SIGN Fracture Care International and Precision OS join efforts to educate surgeons around the globe.

VANCOUVER, British Columbia, April 15th, 2020 — Epic MegaGrants recipient, Precision OS Technology, announced today a first-of-its-kind partnership that makes virtual reality (VR) surgical training for orthopedic surgeons available to physicians worldwide, expanding fracture care to 5 billion people in the world’s developing countries.

According to a 2015 report by The Lancet Commission, 40 percent of hospitals in developing countries provide surgical care for open fractures. The lack of access to treatment for such injuries, routinely available in the developed world, leads to a significant economic burden on patients and their families. There is an urgent need to train more surgical specialists to serve these regions.

“From the day we founded the company, we had a vision for using the immense scalability of virtual reality training to improve surgeon training and raise the standard of care worldwide,” states Danny Goel, M.D., CEO and co-founder of Precision OS. “SIGN Fracture Care International has been dedicated to that same mission and we are proud to support their work. We are grateful to our partners in this effort who are helping us to realize our collective vision.”

SIGN Fracture Care is a humanitarian organization that gives the injured poor access to fracture surgery by donating orthopedic education and implant systems to surgeons in developing countries. Educating local surgeons to care for and treat patients in their home communities builds sustainable orthopedic capacity and improves the quality of life and longevity for people in low- and middle-income countries.

The use of VR education will allow SIGN Fracture Care to expand its training efforts beyond their current methods. Currently they serve in 53 countries and 365 hospitals.  They will distribute Oculus Quest wireless VR headsets among their hospitals and teach remotely using the “multiplayer” option supported by the Precision OS system. Two surgeons and SIGN Board Members, David Shearer, M.D. and Richard Gellman, M.D., will deliver the training alongside the founder and president of SIGN Fracture Care, Lewis Zirkle M.D.

“As it stands we have to spend several months a year traveling or flying surgeons to our headquarters to do training with the SIGN System,” says Dr. Shearer. “With VR, we have the opportunity to provide high-quality training remotely, which can markedly reduce the time and expense required. This has the potential to free up resources to train more surgeons, invest in manufacturing, and ultimately achieve greater impact.”

Dr. Zirkle says, “It is a pleasure to explore the educational opportunities to teach surgeons in developing countries about techniques and indications for orthopedic surgery. It is exciting to expand our training capabilities, and we want to thank Precision OS for the donation of the Oculus Quest based training solution.”

The Precision OS team is using the Unreal Game Engine from Epic Games as the technology foundation of their training solution. “Epic Games continues to support their advances in training simulation to improve healthcare delivery. Despite a very mature use of physical simulation, the healthcare domain is still at the infancy of its adoption of digital training, by making Unreal Engine more user friendly we empower subject matter experts to build training solutions for all” Sebastien Loze, Simulations Industry Manager at Epic Games.

The collaboration recognizes the growing importance and use of virtual reality for physician training, specifically in orthopedic surgery. Compared to conventional training modalities, virtual and augmented reality impart a new depth of contextual learning by improving understanding, technical skills and surgical readiness. VR surgical training introduces a new era of on-demand training that is cost effective and scalable.

Through VR training and education, surgeons will virtually practice and learn how to perform implant procedures as many times as required in order to acquire critical skills and confidence. This breakthrough in surgical training is especially important to SIGN Fracture Care, since new surgeons must train with an experienced SIGN Surgeon before the organization donates implants or instruments. SIGN Fracture Care will now have the ability to use the data gathered by the Precision OS system to monitor and track surgeon progress.

“Our goal and mission has been to provide the highest quality of education on a global scale”, says Dr. Goel. “I have significant admiration for the work that Dr. Zirkle and SIGN Fracture Care have been doing. To be involved in this capacity is extremely humbling for all us at PrecisionOS.”

To learn more about the program launch and success stories go to www.precisionostech.com

Media Contact

Jalila Singerff | Jive PR + Digital
e: jalila@jiveprdigital.com
m: 613.614.6777

About Precision OS

Precision OS was founded by a team of clinical orthopedic surgeons and game developers to create the most relevant and applicable medical-grade-VR-simulation™ experience. Based in Vancouver, British Columbia and backed by the prestigious AO Foundation, the company’s mission is to provide first-in-class orthopedic surgical training on a global scale. Given its focus on surgical education, Precision OS is not only a CME provider through the Royal College of Physicians and Surgeons of Canada, but has also established partnerships with more than 10 North American orthopedic residency programs and medical institutions. The company’s scientifically validated product has been tested among its end users and customers resulting in business relationships with some of the top orthopedic companies in the industry.

About SIGN Fracture Care International

SIGN Fracture Care International has been empowering local surgeons to treat their poor patients in developing countries for 20 years. Our model is to provide orthopedic education to surgeons in developing countries, then donate appropriate instruments and implants so they can treat patients with severe fractures. SIGN Fracture Care has helped more than 250,000 patients in 53 developing countries recover from broken bones and traumatic injuries. To learn more, visit www.signfracturecare.org.

About Epic Games

Founded in 1991, Epic Games is the creator of Fortnite, Battle Breakers, Unreal, Gears of War, Shadow Complex, and the Infinity Blade series of games. Epic’s Unreal Engine technology, the world’s most open and advanced real-time 3D platform, is freely available at unrealengine.com. The Epic Games Store offers a handpicked library of games, available at epicgames.com. Follow @EpicGames for updates.

About Unreal Engine

Epic Games’ Unreal Engine is the world’s most open and advanced real-time 3D platform. Creators across games, film, television, architecture, automotive and transportation, advertising, live events, and training and simulation choose Unreal to deliver cutting-edge content, interactive experiences, and immersive virtual worlds. Follow @UnrealEngine and download Unreal for free at unrealengine.com.

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About PrecisionOS

PrecisionOS is a leader in virtual reality-enabled surgical education. Trusted by top academic medical centers, health systems, and professional societies worldwide, the company delivers an immersive, scalable training ecosystem designed by surgeons for residents and the next generation of healthcare professionals. By combining high-fidelity VR cadaver labs with on-the-go access via the Approaches mobile module and AI-driven performance reporting, PrecisionOS ensures surgeons are ready for the OR, today.

Frequently Asked Questions

Is there a step-by-step "Quick Start" guide for residents?

Yes—The Onboarding Course is your fastest path to proficiency. It walks you through account syncing, procedure selection, and your first virtual rehearsal step-by-step, ensuring you are “OR Ready” before you pick up the controllers.

Action: Follow the guided video path to standardize your learning experience.

Yes. PrecisionOS is compatible with Meta Quest 3, and 3s. If you already own a headset, you simply need to download the PrecisionOS Launcher from the App Store and sign in with your institution email and membership credentials.

Action: Download the launcher and log in.

Your Individual Membership is a month-to-month subscription ($99/mo) designed for residents who want 24/7 access to surgical rehearsal without a long-term contract.  Reach out for information about an institutional membership.

Action: Your card is billed every 30 days from the date of signup.

Hospital networks will often require a MAC address for device white-listing. You can find this in your Meta Quest headset settings under About > MAC Address.

Action: Reach out to provide your IT department with the MAC address found in your headset settings.

Both the headset firmware and the PrecisionOS app must be up to date to prevent technical glitches. Go to Settings > Software Update on your Quest and check the Launcher for app updates.

Action: Enable “Auto-updates” in your headset settings.

About The Author

Picture of Danny P. Goel, MD

Danny P. Goel, MD

Is the CEO of PrecisionOS and is a practicing surgeon and surgical educator. Dr. Goel currently practices in the Vancouver, B.C. area and also serves on the University of British Columbia’s Faculty of Medicine in the Department of Orthopedic Surgery.

He received his medical degree from the University of Manitoba, pursued his residency training in orthopedic surgery at the University of Calgary, and completed fellowship training in shoulder surgery at the University of Western Ontario and Harvard University.

Goel has co-authored more than 30 publications, and is widely sought as a presenter on surgical techniques.

21 Months of Automated VR Data

MAJOR ACADEMIC ORTHOPAEDIC RESIDENCY PROGRAM

How self-directed VR practice fills the seams of the clinical day and produces measurable learning trajectories—completely automatically.

Executive Summary:

Over a 21-month period, 30 orthopaedic residents integrated immersive VR into their training curriculum. With a simple, weekly requirement for residents to practice in headset, the platform seamlessly captured over 88,000 structured data points across 2,566 practice sessions. The resulting data proved that when residents have access to high-fidelity, frictionless simulation and are motivated, they will hone their skills and demonstrate clear performance improvements.

Frictionless Adoption: Practice doesn't compete with clinical time. The data revealed that 45% of all sessions happened organically during lunch breaks or on weekends.

Comprehensive Coverage: Usage wasn't limited to a single subspecialty. Residents attempted 61 distinct cases across 27 procedure modules, proving active engagement from Foundations & Anatomy to Complex Trauma.

Measurable Improvement: The platform didn't just track usage; it tracked skill acquisition. Across 288 scored playthroughs, longitudinal data showed a clear performance signal, with residents demonstrating an average positive learning delta of +0.36 over time.

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Own Your Progress.

Download the PrecisionOS mobile app to access Delphi’s insight reports and turn every VR session into a springboard for future success.

Step #1

State Your Intent

Tell Delphi, your AI Attending Mentor, what you are looking to practice.

Step #2

Get Practice Recommendations

Based on your request, Delphi will suggest personalized VR apps and Video training.

Step #3

Queue Apps In VR

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Step #4

Learn From Experts

Access the video library for expert-led Virtual Grand Rounds and discover surgical pearls from industry leaders and device experts.

Step #4

Practice With A Plan

Go through the recommended VR apps to gain the skills and repetition needed for success. 

Step #5

Review Performance Insights

After your VR session, review your personalized performance insight on your phone to maximine your OR success. 

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Dr. Andrew Maeso

Orthopedic resident

From Uncertainty to Execution

“You already have a plan, now you’re just executing it.”

The Story: Bridging the "Intern Gap"

Dr. Andrew Maeso recognizes the steep reality of residency: “As an intern, you are thrown into the fire.” For him, the hurdle wasn’t just the surgery—it was the invisible mechanics (positioning, X-ray angles, and workflow) that move too fast to learn in a high-pressure OR.

The Solution: Access Over Policy

By bringing the PrecisionOS ecosystem home, Dr. Maeso replaced passive YouTube watching with active mental rehearsal. This allowed him to arrive in the OR with the “steps” already hard-coded into his muscle memory.

The Game Changer: Personal headsets issued for at-home, 24/7 training.

Clinical Focus: Mastery of Antegrade Femoral Nails and Shoulder Arthroscopy.

Program Growth: Experience led to secured funding for all incoming residents.

Smiling man wearing glasses and checkered shirt in an office setting.

Roberto Oliveira

Founder

Over his 25 years in the gaming industry, Roberto Oliveira has been known for bringing stunning realism and high fidelity to interactive experiences.

He combines an art director’s artistic vision with solid business leadership, including experience in building art teams, creative team management, project planning, project management and business development.

Over the years, his talents have been showcased in projects for major publishers including Sony, Activision, Disney and Electronic Arts.

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Dr. Ryan Lohre

MGH Staff Surgeon

From Resident to MGH Staff Surgeon

“Prepare like it matters. Because in the OR—it does.”

The Story: The Currency of Trust

Dr. Ryan Lohre’s trajectory changed during a complex pediatric case that had already seen two failed attempts by tenured surgeons. While textbooks offered the theory, Dr. Lohre used VR to master the 3D spatial intelligence required to build a mental model of the deformity and navigate C-arm imagery in real-time.

The Solution: The 18-Minute Sandbox

The night before surgery, Dr. Lohre rehearsed the procedure four times in VR from his own home. This high-fidelity rehearsal allowed him to arrive in the OR functioning at 80-90% proficiency, compared to the typical 10-20% for a resident facing a new, complex procedure.

The Game Changer: 18 minutes of at-home VR prep for a complex pediatric case.

Clinical Focus: Spatial intelligence for C-arm interpretation and screw trajectory.

Program Growth: Transitioned from trainee to Staff Surgeon at Mass General.

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Dr. Barry McDonough

Program Director

Teaching with Surgical Efficiency

“I let the junior resident do more than ever before—and still finished on time.”

The Story: Reclaiming the OR

While at West Virginia University (WVU), Dr. Barry McDonough faced a universal challenge: balancing resident education with strict OR efficiency. By the time residents step into the OR, foundational skills like camera handling and triangulation should be second nature—not a distraction that slows down the case.

The Solution: Independent Preparation

Residents were assigned just 10 minutes of asynchronous VR training per week. This allowed them to master the “invisible” basics of arthroscopy on their own time. With an average of 17 sessions completed during the pilot, residents arrived with a mental roadmap that translated into immediate technical fluency.

The Game Changer: Asynchronous prep—residents train independently at home.

Clinical Focus: Mastery of triangulation, scope control, and anchor placement.

Program Growth: Model expanded across trauma, spine, and upper extremity.

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Dr. Charlie Spieser

Orthopedic Resident

Mastering the Visuo-Spatial Gap

“VR practice shifts questioning from case generalizations to technique refinement.”

The Story: From Application to Confidence

Charlie Spieser highlights a universal resident hurdle: the high-stress transition from “book knowledge” to real-world execution. Early in training, the fear of making irreversible decisions can lead to hesitation. To bridge this gap, Charlie utilized VR as a daily resource for kinetic learning and anatomical association.

The Solution: Refining Spatial Intelligence

Unlike textbooks or passive videos, PrecisionOS allowed Charlie to practice high-stakes approaches—such as the anterior total hip—in a guided, 3D environment. This repetition provided a “safe sandbox” to identify why errors occurred, building the visuo-spatial confidence required to navigate complex anatomy before ever entering the OR.

The Game Changer: Daily Integration—normalized as an expected program resource.

Clinical Focus: Anterior Total Hip and Deltopectoral surgical approaches.

Program Growth: Nuanced Mentorship—shifting focus to specific faculty preferences.

Orthopaedic virtual reality training for junior residents in surgery.

Immersive Virtual Reality Training for a Junior Orthopaedic Surgery Resident

Andres D Maeso, DO, Michael R McDermott, DO, Jerrod A Steimle, DO

How consistent iVR training accelerates technical fluency and attending trust for first-year residents.

Executive Summary: This case study follows a first-year resident’s integration of immersive VR (iVR) into their surgical curriculum. By dedicating consistent training time to virtual modules, the resident was able to master procedural steps and receive real-time feedback in a risk-free environment before ever stepping into the operating room. The study highlights that this deliberate practice led to a “noticeable improvement in overall efficiency” and significantly increased the attending’s trust and confidence in the resident’s intraoperative capabilities.

Source Attribution: Immersive Virtual Reality Training for a Junior Orthopaedic Surgery Resident, Journal of Orthopaedic Experience & Innovation (2025).

Muscle Memory Development: The repetitive nature of immersive VR (iVR) training, combined with constant real-time feedback, allows technical surgical steps to become deep-seated muscle memory.

Measurable Efficiency Gains: Residents utilizing the platform observe a "noticeable improvement" in overall efficiency and technical proficiency when performing complex orthopedic procedures.

Accelerated Attending Trust: Preoperative rehearsal in a virtual environment significantly increases attending surgeon confidence, directly leading to increased autonomy for the resident in the operating room.

Professional man in business attire for PrecisionOS.

Danny P. Goel, MD

Chief Executive Officer

A practicing surgeon and surgical educator, Dr. Goel currently practices in the Vancouver, B.C. area and also serves on the University of British Columbia’s Faculty of Medicine in the Department of Orthopedic Surgery.

He received his medical degree from the University of Manitoba, pursued his residency training in orthopedic surgery at the University of Calgary, and completed fellowship training in shoulder surgery at the University of Western Ontario and Harvard University.

Goel has co-authored more than 30 publications, and is widely sought as a presenter on surgical techniques.

Professional man smiling in a blue shirt for PrecisionOS About Us page.

Colin O'Connor

Founder

Colin O’Connor brings a proven track record as a business leader and entrepreneur, as well as expertise at developing cutting-edge technology to create immersive, high-fidelity experiences.

He has overseen and played key leadership roles in the highest echelons of the video game industry, founding companies and taking more than 16 top-tier titles to market.

He has worked at the forefront in innovating new rendering technologies in the areas of lighting, motion, particle graphics and shading that bring unprecedented realism to interactive experiences.

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