1
|
Bogar PZ, Virag M, Bene M, Hardi P, Matuz A, Schlegl AT, Toth L, Molnar F, Nagy B, Rendeki S, Berner-Juhos K, Ferencz A, Fischer K, Maroti P. Validation of a novel, low-fidelity virtual reality simulator and an artificial intelligence assessment approach for peg transfer laparoscopic training. Sci Rep 2024; 14:16702. [PMID: 39030307 PMCID: PMC11271545 DOI: 10.1038/s41598-024-67435-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 07/11/2024] [Indexed: 07/21/2024] Open
Abstract
Simulators are widely used in medical education, but objective and automatic assessment is not feasible with low-fidelity simulators, which can be solved with artificial intelligence (AI) and virtual reality (VR) solutions. The effectiveness of a custom-made VR simulator and an AI-based evaluator of a laparoscopic peg transfer exercise was investigated. Sixty medical students were involved in a single-blinded randomised controlled study to compare the VR simulator with the traditional box trainer. A total of 240 peg transfer exercises from the Fundamentals of Laparoscopic Surgery programme were analysed. The experts and AI-based software used the same criteria for evaluation. The algorithm detected pitfalls and measured exercise duration. Skill improvement showed no significant difference between the VR and control groups. The AI-based evaluator exhibited 95% agreement with the manual assessment. The average difference between the exercise durations measured by the two evaluation methods was 2.61 s. The duration of the algorithmic assessment was 59.47 s faster than the manual assessment. The VR simulator was an effective alternative practice compared with the training box simulator. The AI-based evaluation produced similar results compared with the manual assessment, and it could significantly reduce the evaluation time. AI and VR could improve the effectiveness of basic laparoscopic training.
Collapse
Affiliation(s)
- Peter Zoltan Bogar
- 3D Printing and Visualisation Centre, University of Pecs, Medical School, Boszorkany Str. 2, Pecs, 7624, Hungary
| | - Mark Virag
- 3D Printing and Visualisation Centre, University of Pecs, Medical School, Boszorkany Str. 2, Pecs, 7624, Hungary
- Department of Public Health Medicine, University of Pecs, Szigeti Str. 12, Pecs, 7624, Hungary
| | - Matyas Bene
- 3D Printing and Visualisation Centre, University of Pecs, Medical School, Boszorkany Str. 2, Pecs, 7624, Hungary
| | - Peter Hardi
- Medical Skills Education and Innovation Centre, Medical School, University of Pecs, Szigeti Str. 12, Pecs, 7624, Hungary
- Department of Surgery and Vascular Surgery, Tolna County Janos Balassa Hospital, Beri Balogh Adam str. 5-7, Szekszard, 7100, Hungary
| | - Andras Matuz
- Department of Behavioural Sciences, Medical School, University of Pecs, Szigeti Str. 12, Pecs, 7624, Hungary
- Szentágothai Research Centre, University of Pecs, Pecs, Ifjusag str. 20., 7624, Hungary
| | - Adam Tibor Schlegl
- Medical Skills Education and Innovation Centre, Medical School, University of Pecs, Szigeti Str. 12, Pecs, 7624, Hungary
- Department of Orthopaedics, Medical School, University of Pecs, Akac Str. 1, Pecs, 7632, Hungary
| | - Luca Toth
- 3D Printing and Visualisation Centre, University of Pecs, Medical School, Boszorkany Str. 2, Pecs, 7624, Hungary.
- Department of Neurosurgery, Medical School, University of Pecs, 2 Ret Street, Pecs, 7624, Hungary.
| | - Ferenc Molnar
- Medical Skills Education and Innovation Centre, Medical School, University of Pecs, Szigeti Str. 12, Pecs, 7624, Hungary
| | - Balint Nagy
- Medical Skills Education and Innovation Centre, Medical School, University of Pecs, Szigeti Str. 12, Pecs, 7624, Hungary
| | - Szilard Rendeki
- Medical Skills Education and Innovation Centre, Medical School, University of Pecs, Szigeti Str. 12, Pecs, 7624, Hungary
| | - Krisztina Berner-Juhos
- Department of Surgical Research and Techniques, Heart and Vascular Centre, Semmelweis University, Nagyvarad Square 4, Budapest, 1089, Hungary
| | - Andrea Ferencz
- Department of Surgical Research and Techniques, Heart and Vascular Centre, Semmelweis University, Nagyvarad Square 4, Budapest, 1089, Hungary
| | - Krisztina Fischer
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA
| | - Peter Maroti
- 3D Printing and Visualisation Centre, University of Pecs, Medical School, Boszorkany Str. 2, Pecs, 7624, Hungary.
- Medical Skills Education and Innovation Centre, Medical School, University of Pecs, Szigeti Str. 12, Pecs, 7624, Hungary.
| |
Collapse
|
2
|
Tica VI, Tica AA, De Wilde RL. The Future in Standards of Care for Gynecologic Laparoscopic Surgery to Improve Training and Education. J Clin Med 2022; 11:jcm11082192. [PMID: 35456285 PMCID: PMC9028106 DOI: 10.3390/jcm11082192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
Standards of care offer doctors and patients the confidence that an established quality, evidence-based, care is provided, and represent a tool for optimal responding to the population’s needs. It is expected that they will increasingly express a multimodal relationship with gynecologic laparoscopy. Laparoscopy is, now, a standard procedure in operative gynecology, standards are embedded in many laparoscopic procedures, standardization of the skills/competency assessment has been progressively developed, and the proof of competency in laparoscopy may become a standard of care. A continuous development of surgical education includes standard equipment (that may bring value for future advance), standardized training, testing (and performance) assessment, educational process and outcome monitoring/evaluation, patients’ care, and protection, etc. Standards of care and training have a reciprocally sustaining relationship, as training is an essential component of standards of care while care is provided at higher standards after a structured training and as credentialing/certification reunites the two. It is envisaged that through development and implementation, the European wide standards of care in laparoscopic surgery (in close harmonization with personalized medicine) would lead to effective delivery of better clinical services and provide excellent training and education.
Collapse
Affiliation(s)
- Vlad I. Tica
- Department of Obstetrics and Gynecology, Doctoral School, University “Ovidius”—Constanta, University Emergency County Hospital of Constanta—Bul. Tomis, 140, Academy of Romanian Scientists, 900591 Constanta, Romania;
| | - Andrei A. Tica
- Department of Pharmacology, University of Medicine and Pharmacy of Craiova, Emergency County Hospital of Craiova, Str. Tabaci, nb. 1, 200534 Craiova, Romania
- Correspondence:
| | - Rudy L. De Wilde
- Pius Hospital, Carl von Ossietzky University, 26121 Oldenburg, Germany;
| |
Collapse
|
3
|
Abstract
PURPOSE OF REVIEW Residency training is a pivotal educational step on the road to becoming a urologist. It combines both clinical and surgical instruction with the goal of producing proficient and compassionate surgeons and clinicians. In this review, we employ a SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) to investigate the current state of urologic residency training. RECENT FINDINGS Urology remains an attractive and competitive residency with varied and complex surgical and medical training. Areas for improvement include standardization of evaluation and feedback, improving resident wellness, and expanding the use of surgical simulation. Workforce issues such as the predicted urologist supply deficit and poor readiness to enter the business of medicine can be addressed at the residency level. Failure to attract and retain underrepresented minorities, increasing burden of student debt, and resident burnout are serious threats to our field. Using a SWOT analysis we identify key areas for expansion, underscore valuable strengths, and provide a working roadmap for improvement of these formative years.
Collapse
Affiliation(s)
- Luke E Sebel
- Division of Urology, Lahey Hospital and Medical Center, Urology, Burlington, MA, USA
| | - Eric G Katz
- Division of Urology, Lahey Hospital and Medical Center, Urology, Burlington, MA, USA
| | - Lara S MacLachlan
- Division of Urology, Lahey Hospital and Medical Center, Urology, Burlington, MA, USA.
| |
Collapse
|
4
|
Alnafisee N, Zafar S, Vedula SS, Sikder S. Current methods for assessing technical skill in cataract surgery. J Cataract Refract Surg 2021; 47:256-264. [PMID: 32675650 DOI: 10.1097/j.jcrs.0000000000000322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/19/2020] [Indexed: 12/18/2022]
Abstract
Surgery is a major source of errors in patient care. Preventing complications from surgical errors in the operating room is estimated to lead to reduction of up to 41 846 readmissions and save $620.3 million per year. It is now established that poor technical skill is associated with an increased risk of severe adverse events postoperatively and traditional models to train surgeons are being challenged by rapid advances in technology, an intensified patient-safety culture, and a need for value-driven health systems. This review discusses the current methods available for evaluating technical skills in cataract surgery and the recent technological advancements that have enabled capture and analysis of large amounts of complex surgical data for more automated objective skills assessment.
Collapse
Affiliation(s)
- Nouf Alnafisee
- From the The Wilmer Eye Institute, Johns Hopkins University School of Medicine (Alnafisee, Zafar, Sikder), Baltimore, and the Department of Computer Science, Malone Center for Engineering in Healthcare, The Johns Hopkins University Whiting School of Engineering (Vedula), Baltimore, Maryland, USA
| | | | | | | |
Collapse
|
5
|
Abstract
PURPOSE OF REVIEW Postgraduate medical training has evolved considerably from an emphasis on hands-on, autonomous learning to a paradigm where simulation technologies are used to introduce and augment certain skill sets. This review is intended to provide an update on surgical simulators and tools for urological trainee education. RECENT FINDINGS We provide an overview of simulation platforms for robotics, endoscopy, and laparoscopic practice and training. In general, these simulators provide face, content, and construct validity. Various educational and evaluation tools have been adopted. Simulation platforms have been developed for technical and non-technical surgical skills, educational bootcamps, and tools for evaluation and feedback. While trainees find the opportunity to practice their skills beneficial, there may be difficulty with access due to cost and availability. Additionally, there is a need for more objective metrics demonstrating improvement in skill or patient outcome.
Collapse
|