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Yamauchi A, Oshita R, Kudo A, Umezawa M, Shimizu R, Kamo S, Fujita Y, Takagi S. Development of a virtual reality simulator for training canine endotracheal intubation technique and evaluation of the educational impacts. Vet J 2024; 307:106203. [PMID: 39069166 DOI: 10.1016/j.tvjl.2024.106203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/19/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024]
Abstract
Virtual reality (VR)-based training has shown some benefits in medical education, supporting skill acquisition, and helping reduce anxiety in real-world settings. However, the use of VR simulators in veterinary education remains limited. This study aimed to introduce a VR simulator to support veterinarian training in canine anaesthesia induction and endotracheal intubation. This study involved a group that learned solely with instructional videos (video group), and one that learned concurrently with the video and VR simulator (VR group). Third- and fourth-year veterinary students were included and underwent a descriptive test on canine endotracheal intubation. Canine endotracheal intubation success rates were compared between the video (n = 364) and VR (n = 60) groups of fifth-year students. A survey on the VR usability was conducted (n=91). The median descriptive test scores improved in the VR (63.3/100) vs the video group (51.5/100). The canine intubation success rates were comparable in the VR and video groups at 84.3 % and 77.4 %, respectively. A total of 90.1 % of the surveyed students rated the ease of use of the simulator highly. Overall, VR simulators were well-received, suggesting benefits in new skill retention. Further studies are required to evaluate the extent of skill improvement through VR-based training, compared to conventional methods, and to assess its impact on student motivation. Evaluating the long-term effects of VR-based training on skill development and retention will also provide a deeper understanding of its educational benefits.
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Affiliation(s)
- A Yamauchi
- Laboratory of small animal surgery, Department of veterinary medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - R Oshita
- Laboratory of small animal surgery, Department of veterinary medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - A Kudo
- Laboratory of small animal surgery, Department of veterinary medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - M Umezawa
- Laboratory of small animal surgery, Department of veterinary medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - R Shimizu
- Laboratory of small animal surgery, Department of veterinary medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - S Kamo
- Laboratory of small animal surgery, Department of veterinary medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - Y Fujita
- Major of Media Theories and Production, Department of Creation and Representation, Faculty of Creation and Representation, Aichi Shukutoku University, 2-9 Katahira, Nagakute, Aichi 480-1197, Japan
| | - S Takagi
- Laboratory of small animal surgery, Department of veterinary medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, Japan.
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Shetty S, Bhat S, Al Bayatti S, Al Kawas S, Talaat W, El-Kishawi M, Al Rawi N, Narasimhan S, Al-Daghestani H, Madi M, Shetty R. The Scope of Virtual Reality Simulators in Radiology Education: Systematic Literature Review. JMIR MEDICAL EDUCATION 2024; 10:e52953. [PMID: 38722205 PMCID: PMC11094427 DOI: 10.2196/52953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/01/2024] [Accepted: 03/31/2024] [Indexed: 05/18/2024]
Abstract
Background In recent years, virtual reality (VR) has gained significant importance in medical education. Radiology education also has seen the induction of VR technology. However, there is no comprehensive review in this specific area. This review aims to fill this knowledge gap. Objective This systematic literature review aims to explore the scope of VR use in radiology education. Methods A literature search was carried out using PubMed, Scopus, ScienceDirect, and Google Scholar for articles relating to the use of VR in radiology education, published from database inception to September 1, 2023. The identified articles were then subjected to a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-defined study selection process. Results The database search identified 2503 nonduplicate articles. After PRISMA screening, 17 were included in the review for analysis, of which 3 (18%) were randomized controlled trials, 7 (41%) were randomized experimental trials, and 7 (41%) were cross-sectional studies. Of the 10 randomized trials, 3 (30%) had a low risk of bias, 5 (50%) showed some concerns, and 2 (20%) had a high risk of bias. Among the 7 cross-sectional studies, 2 (29%) scored "good" in the overall quality and the remaining 5 (71%) scored "fair." VR was found to be significantly more effective than traditional methods of teaching in improving the radiographic and radiologic skills of students. The use of VR systems was found to improve the students' skills in overall proficiency, patient positioning, equipment knowledge, equipment handling, and radiographic techniques. Student feedback was also reported in the included studies. The students generally provided positive feedback about the utility, ease of use, and satisfaction of VR systems, as well as their perceived positive impact on skill and knowledge acquisition. Conclusions The evidence from this review shows that the use of VR had significant benefit for students in various aspects of radiology education. However, the variable nature of the studies included in the review reduces the scope for a comprehensive recommendation of VR use in radiology education.
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Affiliation(s)
- Shishir Shetty
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Supriya Bhat
- Department of Oral Medicine and Radiology, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore, India
| | - Saad Al Bayatti
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Sausan Al Kawas
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Wael Talaat
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed El-Kishawi
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Natheer Al Rawi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Sangeetha Narasimhan
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hiba Al-Daghestani
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Medhini Madi
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Raghavendra Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
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Lee S, Shetty AS, Cavuoto L. Modeling of Learning Processes Using Continuous-Time Markov Chain for Virtual-Reality-Based Surgical Training in Laparoscopic Surgery. IEEE TRANSACTIONS ON LEARNING TECHNOLOGIES 2023; 17:462-473. [PMID: 38617582 PMCID: PMC11013959 DOI: 10.1109/tlt.2023.3236899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Recent usage of Virtual Reality (VR) technology in surgical training has emerged because of its cost-effectiveness, time savings, and cognition-based feedback generation. However, the quantitative evaluation of its effectiveness in training is still not studied thoroughly. This paper demonstrates the effectiveness of a VR-based surgical training simulator in laparoscopic surgery and investigates how stochastic modeling represented as Continuous-time Markov-chain (CTMC) can be used to explicit the training status of the surgeon. By comparing the training in real environments and in VR-based training simulators, the authors also explore the validity of the VR simulator in laparoscopic surgery. The study further aids in establishing learning models of surgeons, supporting continuous evaluation of training processes for the derivation of real-time feedback by CTMC-based modeling.
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Affiliation(s)
- Seunghan Lee
- Industrial and Systems Engineering Department at Mississippi State University
| | | | - Lora Cavuoto
- Industrial and Systems Engineering at the University at Buffalo, Buffalo, NY, USA
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Gasteiger N, van der Veer SN, Wilson P, Dowding D. How, for Whom, and in Which Contexts or Conditions Augmented and Virtual Reality Training Works in Upskilling Health Care Workers: Realist Synthesis. JMIR Serious Games 2022; 10:e31644. [PMID: 35156931 PMCID: PMC8893595 DOI: 10.2196/31644] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/16/2021] [Accepted: 10/12/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Using traditional simulators (eg, cadavers, animals, or actors) to upskill health workers is becoming less common because of ethical issues, commitment to patient safety, and cost and resource restrictions. Virtual reality (VR) and augmented reality (AR) may help to overcome these barriers. However, their effectiveness is often contested and poorly understood and warrants further investigation. OBJECTIVE The aim of this review is to develop, test, and refine an evidence-informed program theory on how, for whom, and to what extent training using AR or VR works for upskilling health care workers and to understand what facilitates or constrains their implementation and maintenance. METHODS We conducted a realist synthesis using the following 3-step process: theory elicitation, theory testing, and theory refinement. We first searched 7 databases and 11 practitioner journals for literature on AR or VR used to train health care staff. In total, 80 papers were identified, and information regarding context-mechanism-outcome (CMO) was extracted. We conducted a narrative synthesis to form an initial program theory comprising of CMO configurations. To refine and test this theory, we identified empirical studies through a second search of the same databases used in the first search. We used the Mixed Methods Appraisal Tool to assess the quality of the studies and to determine our confidence in each CMO configuration. RESULTS Of the 41 CMO configurations identified, we had moderate to high confidence in 9 (22%) based on 46 empirical studies reporting on VR, AR, or mixed simulation training programs. These stated that realistic (high-fidelity) simulations trigger perceptions of realism, easier visualization of patient anatomy, and an interactive experience, which result in increased learner satisfaction and more effective learning. Immersive VR or AR engages learners in deep immersion and improves learning and skill performance. When transferable skills and knowledge are taught using VR or AR, skills are enhanced and practiced in a safe environment, leading to knowledge and skill transfer to clinical practice. Finally, for novices, VR or AR enables repeated practice, resulting in technical proficiency, skill acquisition, and improved performance. The most common barriers to implementation were up-front costs, negative attitudes and experiences (ie, cybersickness), developmental and logistical considerations, and the complexity of creating a curriculum. Facilitating factors included decreasing costs through commercialization, increasing the cost-effectiveness of training, a cultural shift toward acceptance, access to training, and leadership and collaboration. CONCLUSIONS Technical and nontechnical skills training programs using AR or VR for health care staff may trigger perceptions of realism and deep immersion and enable easier visualization, interactivity, enhanced skills, and repeated practice in a safe environment. This may improve skills and increase learning, knowledge, and learner satisfaction. The future testing of these mechanisms using hypothesis-driven approaches is required. Research is also required to explore implementation considerations.
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Affiliation(s)
- Norina Gasteiger
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, United Kingdom
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Sabine N van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Paul Wilson
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Dawn Dowding
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, United Kingdom
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Aydın A, Ahmed K, Baig U, Raison N, Lantz Powers AG, Macchione N, Al-Jabir A, Abe T, Khan MS, Dasgupta P. The SIMULATE ureteroscopy training curriculum: educational value and transfer of skills. World J Urol 2021; 39:3615-3621. [PMID: 33533996 PMCID: PMC8510983 DOI: 10.1007/s00345-021-03604-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
Objective Different simulation modalities may be utilised in a curricular fashion to benefit from the strengths of each training model. The aim of this study is to evaluate a novel multi-modality ureterorenoscopy (URS) simulation curriculum in terms of educational value, content validity, transfer of skills and inter-rater reliability. Methods This international prospective study recruited urology residents (n = 46) with ≤ 10 URS experience and no prior simulation training. Participants were guided through each phase of the expert-developed SIMULATE URS curriculum by trainers and followed-up in the operating room (OR). Video recordings were obtained during training. A post-training evaluation survey was distributed to evaluate content validity and educational value, using descriptive statistics. Performance was evaluated using the objective structured assessment of technical skills (OSATS) scale to measure improvement in scores throughout the curriculum. Pearson’s correlation coefficient and Cohen’s kappa tests were utilised to investigate correlation and agreement between raters. Results Participants reported gaining OR-transferrable skills (Mean: 4.33 ± 0.67) and demonstrated marked improvement in throughout the curriculum, transferred to the OR for both semi-rigid URS (p = 0.004) and flexible URS (p = 0.007). 70% of participants were successfully followed-up in the OR (n = 32). No differences were identified with the additional use of fresh frozen cadavers (p = 0.85, p = 0.90) and the URO Mentor VR simulator (p = 0.13, p = 0.22). A moderate level of correlation was noted on the video OSATS assessments, between two expert assessors (r = 0.70), but a poor agreement with the live rating. Conclusion The SIMULATE URS training curriculum received high educational value from participants, who demonstrated statistically significant improvement with consecutive cases throughout the curriculum and transferability of skills to the OR in both semi-rigid and flexible URS. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-021-03604-w.
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Affiliation(s)
- Abdullatif Aydın
- MRC Centre for Transplantation, King's College London, King's Health Partners, London, UK.
| | - Kamran Ahmed
- MRC Centre for Transplantation, King's College London, King's Health Partners, London, UK.,Department of Urology, King's College Hospital NHS Foundation Trust, King's Health Partners, London, UK
| | - Umair Baig
- MRC Centre for Transplantation, King's College London, King's Health Partners, London, UK
| | - Nicholas Raison
- MRC Centre for Transplantation, King's College London, King's Health Partners, London, UK
| | | | - Nicola Macchione
- Department of Urology, ASST Santi Paolo E Carlo, Università Degli Studi Di Milano, Milan, Italy
| | - Ahmed Al-Jabir
- MRC Centre for Transplantation, King's College London, King's Health Partners, London, UK
| | - Takashige Abe
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Muhammad Shamim Khan
- MRC Centre for Transplantation, King's College London, King's Health Partners, London, UK.,Urology Centre, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, King's College London, King's Health Partners, London, UK.,Urology Centre, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, UK
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Leijte E, de Blaauw I, Rosman C, Botden SMBI. Assessment of validity evidence for the RobotiX robot assisted surgery simulator on advanced suturing tasks. BMC Surg 2020; 20:183. [PMID: 32787831 PMCID: PMC7430880 DOI: 10.1186/s12893-020-00839-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/30/2020] [Indexed: 01/24/2023] Open
Abstract
Background Robot assisted surgery has expanded considerably in the past years. Compared to conventional open or laparoscopic surgery, virtual reality (VR) training is an essential component in learning robot assisted surgery. However, for tasks to be implemented in a curriculum, the levels of validity should be studied for proficiency-based training. Therefore, this study was aimed to assess the validity evidence of advanced suturing tasks on a robot assisted VR simulator. Method Participants were voluntary recruited and divided in the robotic experienced, laparoscopic experienced or novice group, based on self-reported surgical experience. Subsequently, a questionnaire on a five-point Likert scale was completed to assess the content validity. Three component tasks of complex suturing were performed on the RobotiX simulator (Task1: tilted plane needle transfer, Task: 2 intracorporal suturing, Task 3: anastomosis needle transfer). Accordingly, the outcome of the parameters was used to assess construct validity between robotic experienced and novice participants. Composite scores (0–100) were calculated from the construct parameters and corresponding pass/fail scores with false positive (FP) and false negative (FN) percentages. Results Fifteen robotic experienced, 26 laparoscopic experienced and 29 novices were recruited. Overall content validity outcomes were scored positively on the realism (mean 3.7), didactic value (mean 4.0) and usability (mean 4.2). Robotic experienced participants significantly outperformed novices and laparoscopic experienced participants on multiple parameters on all three tasks of complex suturing. Parameters showing construct validity mainly consisted of movement parameters, needle precision and task completion time. Calculated composite pass/fail scores between robotic experienced and novice participants resulted for Task 1 in 73/100 (FP 21%, FN 5%), Task 2 in 85/100 (FP 28%, FN 4%) and Task 3 in 64/100 (FP 49%, FN 22%). Conclusion This study assessed the validity evidence on multiple levels of the three studied tasks. The participants score the RobotiX good on the content validity level. The composite pass/fail scores of Tasks 1 and 2 allow for proficiency-based training and could be implemented in a robot assisted surgery training curriculum.
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Affiliation(s)
- Erik Leijte
- Department of Surgery, Radboud University Medical Center, Geert grooteplein 10 route 618, 6500HB, Nijmegen, The Netherlands. .,Department of Pediatric Surgery, Radboud University Medical Center, Geert grooteplein 10 route 618, 6500HB, Nijmegen, The Netherlands.
| | - Ivo de Blaauw
- Department of Pediatric Surgery, Radboud University Medical Center, Geert grooteplein 10 route 618, 6500HB, Nijmegen, The Netherlands
| | - Camiel Rosman
- Department of Surgery, Radboud University Medical Center, Geert grooteplein 10 route 618, 6500HB, Nijmegen, The Netherlands
| | - Sanne M B I Botden
- Department of Pediatric Surgery, Radboud University Medical Center, Geert grooteplein 10 route 618, 6500HB, Nijmegen, The Netherlands
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Witthaus MW, Farooq S, Melnyk R, Campbell T, Saba P, Mathews E, Ezzat B, Ertefaie A, Frye TP, Wu G, Rashid H, Joseph JV, Ghazi A. Incorporation and validation of clinically relevant performance metrics of simulation (CRPMS) into a novel full-immersion simulation platform for nerve-sparing robot-assisted radical prostatectomy (NS-RARP) utilizing three-dimensional printing and hydrogel casting technology. BJU Int 2019; 125:322-332. [PMID: 31677325 DOI: 10.1111/bju.14940] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To incorporate and validate clinically relevant performance metrics of simulation (CRPMS) into a hydrogel model for nerve-sparing robot-assisted radical prostatectomy (NS-RARP). MATERIALS AND METHODS Anatomically accurate models of the human pelvis, bladder, prostate, urethra, neurovascular bundle (NVB) and relevant adjacent structures were created from patient MRI by injecting polyvinyl alcohol (PVA) hydrogels into three-dimensionally printed injection molds. The following steps of NS-RARP were simulated: bladder neck dissection; seminal vesicle mobilization; NVB dissection; and urethrovesical anastomosis (UVA). Five experts (caseload >500) and nine novices (caseload <50) completed the simulation. Force applied to the NVB during the dissection was quantified by a novel tension wire sensor system fabricated into the NVB. Post-simulation margin status (assessed by induction of chemiluminescent reaction with fluorescent dye mixed into the prostate PVA) and UVA weathertightness (via a standard 180-mL leak test) were also assessed. Objective scoring, using Global Evaluative Assessment of Robotic Skills (GEARS) and Robotic Anastomosis Competency Evaluation (RACE), was performed by two blinded surgeons. GEARS scores were correlated with forces applied to the NVB, and RACE scores were correlated with UVA leak rates. RESULTS The expert group achieved faster task-specific times for nerve-sparing (P = 0.007) and superior surgical margin results (P = 0.011). Nerve forces applied were significantly lower for the expert group with regard to maximum force (P = 0.011), average force (P = 0.011), peak frequency (P = 0.027) and total energy (P = 0.003). Higher force sensitivity (subcategory of GEARS score) and total GEARS score correlated with lower nerve forces (total energy in Joules) applied to NVB during the simulation with a correlation coefficient (r value) of -0.66 (P = 0.019) and -0.87 (P = 0.000), respectively. Both total and force sensitivity GEARS scores were significantly higher in the expert group compared to the novice group (P = 0.003). UVA leak rate highly correlated with total RACE score r value = -0.86 (P = 0.000). Mean RACE scores were also significantly different between novices and experts (P = 0.003). CONCLUSION We present a realistic, feedback-driven, full-immersion simulation platform for the development and evaluation of surgical skills pertinent to NS-RARP. The correlation of validated objective metrics (GEARS and RACE) with our CRPMS suggests their application as a novel method for real-time assessment and feedback during robotic surgery training. Further work is required to assess the ability to predict live surgical outcomes.
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Affiliation(s)
- Michael W Witthaus
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
| | - Shamroz Farooq
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Rachel Melnyk
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
| | - Timothy Campbell
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Patrick Saba
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
| | - Eric Mathews
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Bahie Ezzat
- Hajim School of Engineering, University of Rochester, Rochester, NY, USA
| | - Ashkan Ertefaie
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Thomas P Frye
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
| | - Guan Wu
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
| | - Hani Rashid
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
| | - Jean V Joseph
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
| | - Ahmed Ghazi
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
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Cecil J, Gupta A, Pirela-Cruz M, Ramanathan P. WITHDRAWN: An IoMT-based Cyber Training Framework for Orthopedic Surgery using Next Generation Internet Technologies. INFORMATICS IN MEDICINE UNLOCKED 2019. [DOI: 10.1016/j.imu.2019.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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9
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Lin CJ, Widyaningrum R. The effect of parallax on eye fixation parameter in projection-based stereoscopic displays. APPLIED ERGONOMICS 2018; 69:10-16. [PMID: 29477316 DOI: 10.1016/j.apergo.2017.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/20/2017] [Accepted: 12/29/2017] [Indexed: 06/08/2023]
Abstract
The promising technology of stereoscopic displays is interesting to explore because 3D virtual applications are widely known. Thus, this study investigated the effect of parallax on eye fixation in stereoscopic displays. The experiment was conducted in three different levels of parallax, in which virtual balls were projected at the screen, at 20 cm and 50 cm in front the screen. The two important findings of this study are that parallax has significant effects on fixation duration, time to first fixation, number of fixations, and accuracy. The participant had more accurate fixations, fewer fixations, shorter fixation durations, and shorter times to first fixation when the virtual ball was projected at the screen than when it was projected at the other two levels of parallax.
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Affiliation(s)
- Chiuhsiang Joe Lin
- Department of Industrial Management, National Taiwan University of Science and Technology, No.43, Sec. 4, Keelung Rd., Da'an Dist., Taipei 10607, Taiwan, ROC.
| | - Retno Widyaningrum
- Department of Industrial Management, National Taiwan University of Science and Technology, No.43, Sec. 4, Keelung Rd., Da'an Dist., Taipei 10607, Taiwan, ROC
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10
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Cruz JASD, Miranda AF, Costa LED, Azevedo RUD, Reis STD, Srougi M, Passerotti CC. Assessment of a new kind of surgical simulator. The physical surgical simulator. Acta Cir Bras 2018; 33:86-94. [PMID: 29412236 DOI: 10.1590/s0102-865020180010000009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/11/2017] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate whether the use of the physical surgical simulator may benefit the development of laparoscopic skills. METHODS Ten medical students were divided into two groups: the first one performed ten weekly training sessions with a physical surgical simulator - ETX A2 LAP and, afterwards, one laparoscopic cholecystectomy in a porcine model, while the second group performed only a laparoscopic cholecystectomy. Both groups were compared regarding bleeding, total surgical time, time to perform each surgical step and qualitative parameters, based on a previously validated tool. RESULTS There was no difference in any of the evaluated parameters. CONCLUSION We did not find any evidence of benefit in the use of the physical simulator for surgical performance in medical students.
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Affiliation(s)
- José Arnaldo Shiomi da Cruz
- MD, MSc, Laboratory of Medical Research, Urology - LIM 55, Medical School, Universidade de São Paulo (USP), Brazil. Conception, design and scientific content of the study; manuscript preparation; critical revision; final approval
| | - André Filipe Miranda
- MD, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Technical procedures, interpretation of data, manuscript preparation
| | - Lucas Evangelista da Costa
- MD, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Technical procedures, interpretation of data, manuscript preparation
| | - Rafael Ulysses de Azevedo
- MD, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Technical procedures, interpretation of data, manuscript preparation
| | - Sabrina Thalita Dos Reis
- PhD, Associate Professor, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Manuscript preparation, critical revision, final approval
| | - Miguel Srougi
- PhD, Full Professor, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Manuscript preparation, critical revision, final approval
| | - Carlo Camargo Passerotti
- PhD, Associate Professor, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Manuscript preparation, critical revision, final approval
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11
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Cecil J, Gupta A, Pirela-Cruz M, Ramanathan P. An IoMT based cyber training framework for orthopedic surgery using Next Generation Internet technologies. INFORMATICS IN MEDICINE UNLOCKED 2018. [DOI: 10.1016/j.imu.2018.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Aydin A, Fisher R, Khan MS, Dasgupta P, Ahmed K. Training, assessment and accreditation in surgery. Postgrad Med J 2017; 93:441-448. [DOI: 10.1136/postgradmedj-2016-134701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/06/2017] [Accepted: 04/02/2017] [Indexed: 12/16/2022]
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Obdeijn MC, Bavinck N, Mathoulin C, van der Horst CMAM, Schijven MP, Tuijthof GJM. Education in wrist arthroscopy: past, present and future. Knee Surg Sports Traumatol Arthrosc 2015; 23:1337-1345. [PMID: 23835770 DOI: 10.1007/s00167-013-2592-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 06/26/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE Arthroscopy has assumed an important place in wrist surgery. It requires specific operative skills that are now mainly acquired in the operating room. In other fields of endoscopic surgery, e-learning and virtual reality (VR) have introduced new perspectives in teaching skills. This leads to the following research question: Could the current way of teaching wrist arthroscopy skills be supported using new educational media, such as e-learning and simulator training? METHOD The literature was searched for available methods of teaching endoscopic skills. Articles were assessed on the evidence of validity. In addition, a survey was sent to all members of the European Wrist Arthroscopy Society (EWAS) to find out whether hand surgeons express a need to embrace modern educational tools such as e-learning or simulators for training of wrist arthroscopy skills. RESULTS This study shows that the current way of teaching wrist arthroscopy skills can be supported using new educational media, such as e-learning and simulator training. Literature indicates that e-learning can be a valuable tool for teaching basic knowledge of arthroscopy and supports the hypothesis that the use of virtual reality and simulators in training enhances operative skills in surgical trainees. This survey indicates that 55 out of 65 respondents feel that an e-learning program would be a valuable asset and 62 out of the 65 respondents are positive on the additional value of wrist arthroscopy simulator in training. CONCLUSION Study results support the need and relevance to strengthen current training of wrist arthroscopy using e-learning and simulator training. LEVEL OF EVIDENCE V.
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Affiliation(s)
- M C Obdeijn
- Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - N Bavinck
- Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - C Mathoulin
- Institut de la Main, Clinique Jouvenet, Paris, France
| | - C M A M van der Horst
- Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - M P Schijven
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - G J M Tuijthof
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
- Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Khan R, Aydin A, Khan MS, Dasgupta P, Ahmed K. Simulation-based training for prostate surgery. BJU Int 2015; 116:665-74. [DOI: 10.1111/bju.12721] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Raheej Khan
- MRC Centre for Transplantation; King's College London; Department of Urology; Guy's Hospital; King's Health Partners; London UK
| | - Abdullatif Aydin
- MRC Centre for Transplantation; King's College London; Department of Urology; Guy's Hospital; King's Health Partners; London UK
| | - Muhammad Shamim Khan
- MRC Centre for Transplantation; King's College London; Department of Urology; Guy's Hospital; King's Health Partners; London UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation; King's College London; Department of Urology; Guy's Hospital; King's Health Partners; London UK
| | - Kamran Ahmed
- MRC Centre for Transplantation; King's College London; Department of Urology; Guy's Hospital; King's Health Partners; London UK
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Empirical evidence, evaluation criteria and challenges for the effectiveness of virtual and mixed reality tools for training operators of car service maintenance. COMPUT IND 2015. [DOI: 10.1016/j.compind.2014.12.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Nickel F, Bintintan VV, Gehrig T, Kenngott HG, Fischer L, Gutt CN, Müller-Stich BP. Virtual reality does not meet expectations in a pilot study on multimodal laparoscopic surgery training. World J Surg 2013; 37:965-73. [PMID: 23430004 DOI: 10.1007/s00268-013-1963-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The purpose of the present study was to determine the value of virtual reality (VR) training for a multimodality training program of basic laparoscopic surgery. MATERIALS AND METHODS Participants in a two-day multimodality training for laparoscopic surgery used box trainers, live animal training, and cadaveric training on the pulsating organ perfusion (POP) trainer in a structured and standardized training program. The participants were divided into two groups. The VR group (n = 13) also practiced with VR training during the program, whereas the control group (n = 14) did not use VR training. The training modalities were assessed using questionnaires with a five-point Likert scale after the program. Concerning VR training, members of the control group assessed their expectations, whereas the VR group assessed the actual experience of using it. Skills performance was evaluated with five standardized test tasks in a live porcine model before (pre-test) and after (post-test) the training program. Laparoscopic skills were measured by task completion time and a general performance score for each task. Baseline tests were compared with laparoscopic experience of all participants for construct validity of the skills test. RESULTS The expected benefit from VR training of the control group was higher than the experienced benefit of the VR group. Box and POP training received better ratings from the VR group than from the control group for some purposes. Both groups improved their skill parameters significantly from pre-training to post-training tests [score +17 % (P < 0.01), time -29 % (P < 0.01)]. No significant difference was found between the two groups for laparoscopic skills improvement except for the score in the instrument coordination task. Construct validity of the skills test was significant for both time and score. CONCLUSIONS At its current level of performance, VR training does not meet expectations. No additional benefit was observed from VR training in our multimodality training program.
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Affiliation(s)
- Felix Nickel
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
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Chien JH, Suh IH, Park SH, Mukherjee M, Oleynikov D, Siu KC. Enhancing Fundamental Robot-Assisted Surgical Proficiency by Using a Portable Virtual Simulator. Surg Innov 2012; 20:198-203. [DOI: 10.1177/1553350612458545] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. The development of a virtual reality (VR) training platform provides an affordable interface. The learning effect of VR and the capability of skill transfer from the VR environment to clinical tasks require more investigation. Methods. Here, 14 medical students performed 2 fundamental surgical tasks—bimanual carrying (BC) and peg transfer (PT)—in actual and virtual environments. Participants in the VR group received VR training, whereas participants in the control group played a 3D game. The learning effect was examined by comparing kinematics between pretraining and posttraining in the da Vinci Surgical System. Differences between VR and playing the 3D game were also examined. Results. Those who were trained with the VR simulator had significantly better performance in both actual PT ( P = .002) and BC ( P < .001) tasks. The time to task completion and the total distance traveled were significantly decreased in both surgical tasks in the VR group compared with the 3D game group. However, playing the 3D game showed no significant enhancement of fundamental surgical skills in the actual PT task. The difference between pretraining and posttraining was significantly larger in the VR group than in the 3D game group in both the time to task completion ( P = .002) and the total distance traveled ( P = .027) for the actual PT task. Participants who played the 3D game seemed to perform even worse in posttraining. Conclusions. Training with the portable VR simulator improved robot-assisted surgical skill proficiency in comparison to playing a 3D game.
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Affiliation(s)
- Jung Hung Chien
- University of Nebraska Medical Center, Omaha, NE, USA
- University of Nebraska at Omaha, Omaha, NE, USA
| | - Irene H. Suh
- University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | | | - Ka-Chun Siu
- University of Nebraska Medical Center, Omaha, NE, USA
- University of Nebraska at Omaha, Omaha, NE, USA
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Schreuder HWR, Wolswijk R, Zweemer RP, Schijven MP, Verheijen RHM. Training and learning robotic surgery, time for a more structured approach: a systematic review. BJOG 2011; 119:137-49. [PMID: 21981104 DOI: 10.1111/j.1471-0528.2011.03139.x] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Robotic assisted laparoscopic surgery is growing rapidly and there is an increasing need for a structured approach to train future robotic surgeons. OBJECTIVES To review the literature on training and learning strategies for robotic assisted laparoscopic surgery. SEARCH STRATEGY A systematic search of MEDLINE, EMBASE, the Cochrane Library and the Journal of Robotic Surgery was performed. SELECTION CRITERIA We included articles concerning training, learning, education and teaching of robotic assisted laparoscopic surgery in any specialism. DATA COLLECTION AND ANALYSIS Two authors independently selected articles to be included. We categorised the included articles into: training modalities, learning curve, training future surgeons, curriculum design and implementation. MAIN RESULTS We included 114 full text articles. Training modalities such as didactic training, skills training (dry lab, virtual reality, animal or cadaver models), case observation, bedside assisting, proctoring and the mentoring console can be used for training in robotic assisted laparoscopic surgery. Several training programmes in general and specific programmes designed for residents, fellows and surgeons are described in the literature. We provide guidelines for development of a structured training programme. AUTHORS' CONCLUSIONS Robotic surgical training consists of system training and procedural training. System training should be formally organised and should be competence based, instead of time based. Virtual reality training will play an import role in the near future. Procedural training should be organised in a stepwise approach with objective assessment of each step. This review aims to facilitate and improve the implementation of structured robotic surgical training programmes.
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Affiliation(s)
- H W R Schreuder
- Division of Women and Baby, Department of Gynaecological Oncology, University Medical Centre Utrecht, The Netherlands.
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Lewis TM, Aggarwal R, Rajaretnam N, Grantcharov TP, Darzi A. Training in surgical oncology - the role of VR simulation. Surg Oncol 2011; 20:134-9. [PMID: 21605972 DOI: 10.1016/j.suronc.2011.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
There have been dramatic changes in surgical training over the past two decades which have resulted in a number of concerns for the development of future surgeons. Changes in the structure of cancer services, working hour restrictions and a commitment to patient safety has led to a reduction in training opportunities that are available to the surgeon in training. Simulation and in particular virtual reality (VR) simulation has been heralded as an effective adjunct to surgical training. Advances in VR simulation has allowed trainees to practice realistic full length procedures in a safe and controlled environment, where mistakes are permitted and can be used as learning points. There is considerable evidence to demonstrate that the VR simulation can be used to enhance technical skills and improve operating room performance. Future work should focus on the cost effectiveness and predictive validity of VR simulation, which in turn would increase the uptake of simulation and enhance surgical training.
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Affiliation(s)
- T M Lewis
- Department of Cancer and Surgery, Room 1029, 10th Floor, QEQM, St. Marys Hospital Imperial College London, UK.
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Recent Trends in Continuing Medical Education Among Obstetrician–Gynecologists. Obstet Gynecol 2011; 117:1060-1064. [DOI: 10.1097/aog.0b013e318214e561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Schreuder HWR, van Dongen KW, Roeleveld SJ, Schijven MP, Broeders IAMJ. Face and construct validity of virtual reality simulation of laparoscopic gynecologic surgery. Am J Obstet Gynecol 2009; 200:540.e1-8. [PMID: 19285646 DOI: 10.1016/j.ajog.2008.12.030] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Revised: 10/26/2008] [Accepted: 12/22/2008] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The objective of the study was to validate virtual reality simulation in assessing laparoscopic skills in gynecology by establishing the extent of realism of the simulation to the actual task (face validity) and the degree to which the results of the test one uses reflects the subject tested (construct validity). STUDY DESIGN Subjects (n = 56) were divided into 3 groups: novices (n = 15), intermediates (n = 20), and experts (n = 21). Participants completed 3 repetitions of a training program consisting of 4 basic skills and 3 gynecologic procedural simulations. The performance was compared between groups using a post hoc Student t test with the Bonferroni technique. Face validity was determined by using a questionnaire of 27 statements. RESULTS Resulting from the questionnaire, the opinion about the realism and training capacities of the tasks was favorable among all groups. The degree of prior laparoscopic experience was reflected in the outcome performance parameters of the tasks. Experts achieved significant better scores on specific parameters. CONCLUSION The results of this study indicate acceptance and thus face validity of the system among both reference (novice, intermediate) and expert group. There is a significant difference between subjects with different laparoscopic experience and thereby construct validity for the laparoscopic simulator could be established.
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Affiliation(s)
- Henk W R Schreuder
- Department of Obstetrics and Gynecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
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