1
|
Kovoor JG, Gupta AK, Gladman MA. Validity and effectiveness of augmented reality in surgical education: A systematic review. Surgery 2021; 170:88-98. [PMID: 33744003 DOI: 10.1016/j.surg.2021.01.051] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Current challenges in surgical training have led to the investigation of augmented reality as a potential method of supplementary education. However, its value for this purpose remains uncertain. The aim of this study was to perform a systematic review of the published literature to evaluate the validity and effectiveness of augmented reality in surgical education, and to compare it with other simulation modalities. METHODS Electronic literature searches were performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two authors independently extracted pertinent data and assessed study quality. The primary outcome measures of interest were the validity and effectiveness of augmented reality as an educational tool. RESULTS Of 6,500 articles, 24 studies met eligibility criteria for inclusion, of which 2 were randomized. Ten studies investigated validity, with 7 establishing both face and content validity and an additional 1 just content validity. Construct validity was demonstrated in 9 of 11 studies. Of the 11 studies that examined the effectiveness of augmented reality in skills acquisition, 9 demonstrated enhanced learning. Of the 5 studies in which the effectiveness of augmented reality as an educational tool was compared with other modes of simulation, augmented reality was found to be superior in 2 and equivalent in the others. CONCLUSION Overall, the majority, including 2 high-quality randomized controlled trials, demonstrated the validity and effectiveness of augmented reality in surgical education. However, the quality of published studies was poor with marked heterogeneity. Although these results are encouraging, additional high-quality studies, preferably in the real-life environment, are required before the widespread implementation of augmented reality within surgical curricula can be recommended.
Collapse
Affiliation(s)
- Joshua G Kovoor
- Adelaide Medical School, Faculty of Health & Medical Sciences, The University of Adelaide, South Australia
| | - Aashray K Gupta
- Adelaide Medical School, Faculty of Health & Medical Sciences, The University of Adelaide, South Australia
| | - Marc A Gladman
- Adelaide Medical School, Faculty of Health & Medical Sciences, The University of Adelaide, South Australia.
| |
Collapse
|
2
|
Urology resident training in laparoscopic surgery - results of the first national survey in Poland. Wideochir Inne Tech Maloinwazyjne 2019; 14:433-441. [PMID: 31534575 PMCID: PMC6748061 DOI: 10.5114/wiitm.2019.81439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/05/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction For many urological procedures the open approach is being replaced by the laparoscopic approach. Laparoscopy technique requires special training conditions. A well-designed, step-by step training program is significantly important for shortening the learning curve. Aim The purpose of the study was to evaluate urology residents’ (UR) experience in laparoscopic procedures, training patterns and facilities available in departments of urology in Poland. Material and methods The survey developed by the authors included 18 questions concerning laparoscopy training and was distributed among UR who participated in 2 courses in laparoscopic surgery for UR in Poland in 2017. The survey consisted of questions regarding the number of laparoscopic procedures, acquired laparoscopic experience, laparoscopic simulation training and motivation for further learning. Results Of the 2017 invited UR in Poland, 108 (34%) completed the survey. Seventy-two (78%) UR from the study group have access to laparoscopic surgery in their department. Only 20 (25%) of urology departments are equipped with a laparoscopy box and a small number of UR perform regular training. As a primary operator basic (varicocele repair) and advanced (e.g. radical nephrectomy, radical prostatectomy, nephron-sparing surgery) laparoscopic procedures are performed respectively by 55 (71%) UR and 8 (10%) UR. Most residents evaluated their laparoscopic skills as poor (15, 19%), very poor (31, 40%) or absent (10, 13%), while only 22 (28%) evaluated them as at least satisfactory. Conclusions Laparoscopic technique is available in most Polish training centers. However, the majority of UR consider their skills unsatisfactory. Additionally, a large number of Polish UR do not have access to intensive training. UR considered that their availability of training courses and fellowships is low. Surgical exposure among Polish UR comprises mainly minor laparoscopic procedures.
Collapse
|
3
|
Kowalewski KF, Minassian A, Hendrie JD, Benner L, Preukschas AA, Kenngott HG, Fischer L, Müller-Stich BP, Nickel F. One or two trainees per workplace for laparoscopic surgery training courses: results from a randomized controlled trial. Surg Endosc 2018; 33:1523-1531. [PMID: 30194644 DOI: 10.1007/s00464-018-6440-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/05/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND There are no standards for optimal utilization of workplaces in laparoscopic training. This study aimed to define whether laparoscopy training should be done alone or in pairs (known as dyad training). METHODS This was a three-arm randomized controlled trial with laparoscopically naïve medical students (n = 100). Intervention groups participated alone (n = 40) or as dyad (n = 40) in a multimodality training curriculum with e-learning, basic, and procedural skills training using box and VR trainers. The control group (n = 20) had no training. Post-performance of a cadaveric porcine laparoscopic cholecystectomy (LC) was measured as the primary outcome by blinded raters using the objective structured assessment of technical skills (OSATS). Global operative assessment of laparoscopic skills (GOALS), time for LC, and VR performances were secondary outcomes. RESULTS There were no differences between groups for performance scores [OSATS: alone (40.2 ± 9.8) vs. dyad (39.8 ± 8.6), p = 0.995; alone vs. control (37.1 ± 7.4), p = 0.548; or dyad vs. control, p = 0.590; and GOALS score: alone (10.6 ± 3.0) vs. dyad (10.0 ± 2.7), p = 0.599; alone vs. control (10.1 ± 3.0), p = 0.748; or dyad vs. control, p = 0.998]. Dyad finished LC faster than control [median = 62.5 min (CI 58.0-73.0) vs. 76.5 min (CI 72.0-80+); p = 0.042], while there were no inter-group differences between alone vs. control [median = 69.0 min (CI 62.0-76.0) vs. control; p = 0.099] or alone vs. dyad (p = 0.840). Dyad and alone showed superior performance on the VR trainer vs. control for time, number of movements, and path length, but not for complications and application of cautery. CONCLUSIONS The curriculum provided trainees with the laparoscopic skills needed to perform LC safely, irrespective of the number of trainees per workplace. Dyad training reduced the operation time needed for LC. Therefore, dyad training seems to be a promising alternative, especially if training time is limited and resources must be used as efficiently as possible. Trial registration German Clinical Trials Register: DRKS00004675.
Collapse
Affiliation(s)
- Karl-Friedrich Kowalewski
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Andreas Minassian
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Jonathan David Hendrie
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Laura Benner
- Institute for Medical Biometry and Informatics, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Anas Amin Preukschas
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Hannes Götz Kenngott
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Lars Fischer
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Beat P Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
| |
Collapse
|
4
|
Dey A, Billinghurst M, Lindeman RW, Swan JE. A Systematic Review of 10 Years of Augmented Reality Usability Studies: 2005 to 2014. Front Robot AI 2018; 5:37. [PMID: 33500923 PMCID: PMC7805955 DOI: 10.3389/frobt.2018.00037] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/19/2018] [Indexed: 11/13/2022] Open
Abstract
Augmented Reality (AR) interfaces have been studied extensively over the last few decades, with a growing number of user-based experiments. In this paper, we systematically review 10 years of the most influential AR user studies, from 2005 to 2014. A total of 291 papers with 369 individual user studies have been reviewed and classified based on their application areas. The primary contribution of the review is to present the broad landscape of user-based AR research, and to provide a high-level view of how that landscape has changed. We summarize the high-level contributions from each category of papers, and present examples of the most influential user studies. We also identify areas where there have been few user studies, and opportunities for future research. Among other things, we find that there is a growing trend toward handheld AR user studies, and that most studies are conducted in laboratory settings and do not involve pilot testing. This research will be useful for AR researchers who want to follow best practices in designing their own AR user studies.
Collapse
Affiliation(s)
- Arindam Dey
- Empathic Computing Laboratory, University of South Australia, Mawson Lakes, SA, Australia
| | - Mark Billinghurst
- Empathic Computing Laboratory, University of South Australia, Mawson Lakes, SA, Australia
| | - Robert W Lindeman
- Human Interface Technology Lab New Zealand (HIT Lab NZ), University of Canterbury, Christchurch, New Zealand
| | - J Edward Swan
- Mississippi State University, Starkville, MS, United States
| |
Collapse
|
5
|
Chen CY, Ragle CA, Lencioni R, Fransson BA. Comparison of 2 training programs for basic laparoscopic skills and simulated surgery performance in veterinary students. Vet Surg 2017; 46:1187-1197. [DOI: 10.1111/vsu.12729] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 04/21/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Chi-Ya Chen
- Department of Veterinary Clinical Sciences; Washington State University; Pullman Washington
| | - Claude A. Ragle
- Department of Veterinary Clinical Sciences; Washington State University; Pullman Washington
| | - Rachael Lencioni
- Department of Veterinary Clinical Sciences; Washington State University; Pullman Washington
| | - Boel A. Fransson
- Department of Veterinary Clinical Sciences; Washington State University; Pullman Washington
| |
Collapse
|
6
|
Schmidt MW, Friedrich M, Kowalewski KF, De La Garza J, Bruckner T, Müller-Stich BP, Nickel F. Learning from the surgeon's real perspective - First-person view versus laparoscopic view in e-learning for training of surgical skills? Study protocol for a randomized controlled trial. Int J Surg Protoc 2017; 3:7-13. [PMID: 31851752 PMCID: PMC6913567 DOI: 10.1016/j.isjp.2017.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/20/2017] [Accepted: 01/21/2017] [Indexed: 10/24/2022] Open
Abstract
Background Surgical proficiency is highly dependent on continuous and efficient training. However, efficacy of training hinges on questions such as accessibility and how intuitively the training can be translated into reality. Minimally invasive surgery (MIS) in particular relies on adequate training modalities in order to compensate for its additional psychomotor and visuospatial challenges. The increasing demand for MIS procedures longs for further enhancement of training and steep learning curves. We are investigating a nouveau training concept that continuously utilizes the first person view as addendum to laparoscopic view. We hypothesize this approach to be more intuitive thus faster and more naturally to apprehend than a laparoscopic view only and aim to establish a new standard to implement into training curricula. Methods and analysis The present study is conducted as a monocentric, two-arm randomized trial. Participants undergo a training curriculum in laparoscopic suturing and knot tying, using e-learning video material with either the first-person perspective of the surgeon or the laparoscopic view only. Primary endpoint is the total training time needed to reach a predefined proficiency level. Participants are evaluated by blinded raters using validated checklists. Number of attempts, procedure and knot quality subscore difference as well as metric parameter analysis from the first and last knots analyzed as secondary endpoints. Furthermore, trainees are assessed with regard to surgical background, basic skills level and spatial awareness. A total sample size of 80 participants for the analysis of the primary endpoint was determined, which will be performed as a two-sided t-test. Ethics and dissemination Ethical approval was obtained from the Ethics Committee of the Medical Faculty at Heidelberg University (Code S-334/2011). This trial was registered with the German Clinical Trials Register (DRKS) in Freiburg, Germany, on May 6th (DRKS00009997). The results will be published and presented at appropriate conferences.
Collapse
Affiliation(s)
- Mona Wanda Schmidt
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Mirco Friedrich
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Karl-Friedrich Kowalewski
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Javier De La Garza
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Thomas Bruckner
- Institute for Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120 Heidelberg, Germany
| | - Beat-Peter Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| |
Collapse
|
7
|
Fransson BA. Advances in Laparoscopic Skills Training and Management. Vet Clin North Am Small Anim Pract 2016; 46:1-12. [DOI: 10.1016/j.cvsm.2015.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
8
|
van der Aa JE, Schreuder HWR. Training Laparoscopic Skills at Home: Residents' Opinion of a New Portable Tablet Box Trainer. Surg Innov 2015; 23:196-200. [PMID: 26464469 DOI: 10.1177/1553350615610654] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine residents' opinion about a new portable box trainer, to see if they would be interested in using this for training at home, and to give an overview of the box trainers that could be used at home. METHODS An expert opinion study was performed among 27 gynecology residents to determine the value of the portable box trainer in training their laparoscopic skills and the value of using it at home. Their opinions were scored on a 5-point Likert scale. RESULTS Gynecology residents very much appreciated the portable box trainer in its design, size, visualization, light source, ability to record, and instruments (all median 4). They felt that the portable box trainer would be effective in training laparoscopic skills in general; in training hand-eye coordination, 3D perception, and tying knots (all median 4); and especially in training basic skills (median 5). Almost all residents would use the portable box trainer if they had one at home (median 5). The literature supports the hypothesis that training laparoscopic skills at home using a box trainer may be effective in acquiring and maintaining laparoscopic skills. CONCLUSIONS Training laparoscopic skills at home using a portable box trainer may be of added value in the laparoscopic training of surgical residents. Residents feel positive about using the new portable box trainer that is presented and appreciate the possibility of training at home.
Collapse
|
9
|
Kenngott HG, Wagner M, Nickel F, Wekerle AL, Preukschas A, Apitz M, Schulte T, Rempel R, Mietkowski P, Wagner F, Termer A, Müller-Stich BP. Computer-assisted abdominal surgery: new technologies. Langenbecks Arch Surg 2015; 400:273-81. [PMID: 25701196 DOI: 10.1007/s00423-015-1289-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Computer-assisted surgery is a wide field of technologies with the potential to enable the surgeon to improve efficiency and efficacy of diagnosis, treatment, and clinical management. PURPOSE This review provides an overview of the most important new technologies and their applications. METHODS A MEDLINE database search was performed revealing a total of 1702 references. All references were considered for information on six main topics, namely image guidance and navigation, robot-assisted surgery, human-machine interface, surgical processes and clinical pathways, computer-assisted surgical training, and clinical decision support. Further references were obtained through cross-referencing the bibliography cited in each work. Based on their respective field of expertise, the authors chose 64 publications relevant for the purpose of this review. CONCLUSION Computer-assisted systems are increasingly used not only in experimental studies but also in clinical studies. Although computer-assisted abdominal surgery is still in its infancy, the number of studies is constantly increasing, and clinical studies start showing the benefits of computers used not only as tools of documentation and accounting but also for directly assisting surgeons during diagnosis and treatment of patients. Further developments in the field of clinical decision support even have the potential of causing a paradigm shift in how patients are diagnosed and treated.
Collapse
Affiliation(s)
- H G Kenngott
- Department of General, Abdominal and Transplant Surgery, Ruprecht-Karls-University, Heidelberg, Germany
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Yiannakopoulou E, Nikiteas N, Perrea D, Tsigris C. Virtual reality simulators and training in laparoscopic surgery. Int J Surg 2014; 13:60-64. [PMID: 25463761 DOI: 10.1016/j.ijsu.2014.11.014] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/12/2014] [Accepted: 11/12/2014] [Indexed: 12/14/2022]
Abstract
Virtual reality simulators provide basic skills training without supervision in a controlled environment, free of pressure of operating on patients. Skills obtained through virtual reality simulation training can be transferred on the operating room. However, relative evidence is limited with data available only for basic surgical skills and for laparoscopic cholecystectomy. No data exist on the effect of virtual reality simulation on performance on advanced surgical procedures. Evidence suggests that performance on virtual reality simulators reliably distinguishes experienced from novice surgeons Limited available data suggest that independent approach on virtual reality simulation training is not different from proctored approach. The effect of virtual reality simulators training on acquisition of basic surgical skills does not seem to be different from the effect the physical simulators. Limited data exist on the effect of virtual reality simulation training on the acquisition of visual spatial perception and stress coping skills. Undoubtedly, virtual reality simulation training provides an alternative means of improving performance in laparoscopic surgery. However, future research efforts should focus on the effect of virtual reality simulation on performance in the context of advanced surgical procedure, on standardization of training, on the possibility of synergistic effect of virtual reality simulation training combined with mental training, on personalized training.
Collapse
Affiliation(s)
- Eugenia Yiannakopoulou
- Faculty of Health and Caring Professions Technological Educational Institute of Athens, Agiou Spyridonos, 12210, Aigaleo Athens, Greece.
| | - Nikolaos Nikiteas
- 2nd Department of Propedeutic Surgery School of Medicine NKUA, Greece
| | - Despina Perrea
- Laboratory for Experimental Surgery and Surgical Research NKUA, Greece
| | | |
Collapse
|
11
|
Nickel F, Jede F, Minassian A, Gondan M, Hendrie JD, Gehrig T, Linke GR, Kadmon M, Fischer L, Müller-Stich BP. One or two trainees per workplace in a structured multimodality training curriculum for laparoscopic surgery? Study protocol for a randomized controlled trial - DRKS00004675. Trials 2014; 15:137. [PMID: 24754961 PMCID: PMC3999459 DOI: 10.1186/1745-6215-15-137] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 04/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Laparoscopy training courses have been established in many centers worldwide to ensure adequate skill learning before performing operations on patients. Different training modalities and their combinations have been compared regarding training effects. Multimodality training combines different approaches for optimal training outcome. However, no standards currently exist for the number of trainees assigned per workplace. METHODS This is a monocentric, open, three-arm randomized controlled trial. The participants are laparoscopically-naive medical students from Heidelberg University. After a standardized introduction to laparoscopic cholecystectomy (LC) with online learning modules, the participants perform a baseline test for basic skills and LC performance on a virtual reality (VR) trainer. A total of 100 students will be randomized into three study arms, in a 2:2:1 ratio. The intervention groups participate individually (Group 1) or in pairs (Group 2) in a standardized and structured multimodality training curriculum. Basic skills are trained on the box and VR trainers. Procedural skills and LC modules are trained on the VR trainer. The control group (Group C) does not receive training between tests. A post-test is performed to reassess basic skills and LC performance on the VR trainer. The performance of a cadaveric porcine LC is then measured as the primary outcome using standardized and validated ratings by blinded experts with the Objective Structured Assessment of Technical Skills. The Global Operative Assessment of Laparoscopic Surgical skills score and the time taken for completion are used as secondary outcome measures as well as the improvement of skills and VR LC performance between baseline and post-test. Cognitive tests and questionnaires are used to identify individual factors that might exert influence on training outcome. DISCUSSION This study aims to assess whether workplaces in laparoscopy training courses for beginners should be used by one trainee or two trainees simultaneously, by measuring the impact on operative performance and learning curves. Possible factors of influence, such as the role of observing the training partner, exchange of thoughts, active reflection, model learning, motivation, pauses, and sympathy will be explored in the data analysis. This study will help optimize the efficiency of laparoscopy training courses. TRIAL REGISTRATION NUMBER DRKS00004675.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Beat P Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
| |
Collapse
|
12
|
Xiao D, Jakimowicz JJ, Albayrak A, Buzink SN, Botden SMBI, Goossens RHM. Face, content, and construct validity of a novel portable ergonomic simulator for basic laparoscopic skills. JOURNAL OF SURGICAL EDUCATION 2014; 71:65-72. [PMID: 24411426 DOI: 10.1016/j.jsurg.2013.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 04/05/2013] [Accepted: 05/20/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Laparoscopic skills can be improved effectively through laparoscopic simulation. The purpose of this study was to verify the face and content validity of a new portable Ergonomic Laparoscopic Skills simulator (Ergo-Lap simulator) and assess the construct validity of the Ergo-Lap simulator in 4 basic skills tasks. DESIGN Four tasks were evaluated: 2 different translocation exercises (a basic bimanual exercise and a challenging single-handed exercise), an exercise involving tissue manipulation under tension, and a needle-handling exercise. Task performance was analyzed according to speed and accuracy. The participants rated the usability and didactic value of each task and the Ergo-Lap simulator along a 5-point Likert scale. SETTING Institutional academic medical center with its affiliated general surgery residency. PARTICIPANTS Forty-six participants were allotted into 2 groups: a Novice group (n = 26, <10 clinical laparoscopic procedures) and an Experienced group (n = 20, >50 clinical laparoscopic procedures). RESULTS The Experienced group completed all tasks in less time than the Novice group did (p < 0.001, Mann-Whitney U test). The Experienced group also completed tasks 1, 2, and 4 with fewer errors than the Novice group did (p < 0.05). Of the Novice participants, 96% considered that the present Ergo-Lap simulator could encourage more frequent practice of laparoscopic skills. In addition, 92% would like to purchase this simulator. All of the experienced participants confirmed that the Ergo-Lap simulator was easy to use and useful for practicing basic laparoscopic skills in an ergonomic manner. Most (95%) of these respondents would recommend this simulator to other surgical trainees. CONCLUSIONS This Ergo-Lap simulator with multiple tasks was rated as a useful training tool that can distinguish between various levels of laparoscopic expertise. The Ergo-Lap simulator is also an inexpensive alternative, which surgical trainees could use to update their skills in the skills laboratory, at home, or in the office.
Collapse
Affiliation(s)
- Dongjuan Xiao
- Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands.
| | - Jack J Jakimowicz
- Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands; Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, the Netherlands; Department of Research and Education, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Armagan Albayrak
- Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - Sonja N Buzink
- Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - Sanne M B I Botden
- Department of Surgery, Máxima Medical Centre, Veldhoven, the Netherlands
| | - Richard H M Goossens
- Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands; Department of Neuroscience, Erasmus MC, Rotterdam, the Netherlands
| |
Collapse
|
13
|
Blackmur JP, Clement RG, Brady RR, Oliver CW. Surgical training 2.0: How contemporary developments in information technology can augment surgical training. Surgeon 2013; 11:105-12. [DOI: 10.1016/j.surge.2012.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 11/27/2012] [Accepted: 12/03/2012] [Indexed: 11/16/2022]
|
14
|
Calise F, Romano M, Ceriello A, Giuliani A, Cozzolino S. The Learning Curve in Laparoscopic Liver Surgery. Updates Surg 2013. [DOI: 10.1007/978-88-470-2664-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
|
15
|
Laparoscopic Surgical Skills programme: preliminary evaluation of Grade I Level 1 courses by trainees. Wideochir Inne Tech Maloinwazyjne 2012; 7:188-92. [PMID: 23256024 PMCID: PMC3516988 DOI: 10.5114/wiitm.2011.28895] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 04/15/2012] [Accepted: 04/23/2012] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION New training models are needed to maintain safety and quality of surgical performance. A simulated setting using virtual reality, synthetic, and/or organic models should precede traditional supervised training in the operating room. AIM The aim of the paper is to describe the Laparoscopic Surgical Skills (LSS) programme and to provide information about preliminary evaluation of Grade I Level 1 courses, including overall quality, applicability of the course content in practice and the balance between theory and hands-on training modules, by participating trainees. MATERIAL AND METHODS During 5 accredited LSS Grade I Level 1 courses held in Eindhoven (the Netherlands), Kosice (Slovak Republic), and Lisbon (Portugal) between April 2011 and January 2012, demographic data and pre-course surgical experience in laparoscopic surgery of the participants were recorded. The final course evaluation form was completed by each participant after the course (anonymous) to evaluate course progress, course materials, assessment, staff, location and overall impression of the course on a 1-10 scale to obtain feedback information. RESULTS Forty-seven surgeons of 5 different nationalities were enrolled in an LSS Grade I Level 1 programme. Most participants were first or second year residents (n = 25), but also already established surgeons took part (n = 6). The mean age of the participants was 31.2 years (SD = 2.86), the male/female ratio was 32/15, and previous experience with laparoscopic surgery was limited. Overall impression of the course was rated with 8.7 points (SD = 0.78). The applicability of the course content in practice and the balance between theory and hands-on training were also rated very well - mean 8.8 (SD = 1.01) and 8.1 points (SD = 0.80) respectively. CONCLUSIONS Laparoscopic Surgical Skills Grade I Level 1 courses are evaluated as well balanced, with content applicable in clinical practice, meeting the expectations of individual participants. International interest in the programme suggests that LSS might become the future European standard in surgical education in laparoscopic surgery. Further conclusions concerning success of the programme may be drawn after the completion of clinical assessment of enrolled participants.
Collapse
|