Sweet R, Kowalewski T, Oppenheimer P, Weghorst S, Satava R
Department of Urology, University of Washington and Human Interface Technology Laboratory, Seattle, Washington 98195-6510, USA.
J Urol. 2004 Nov;172(5 Pt 1):1953-7. doi: 10.1097/01.ju.0000141298.06350.4c.
We examined the face, content and construct validity of version 1.0 of the University of Washington transurethral prostate resection (TURP) trainer.
Version 1.0 of a virtual reality based simulator for transurethral skills was developed at our laboratory by integrating TURP hardware with our virtual 3-dimensional anatomy, irrigation control, cutting, bleeding and haptics force feedback. A total of 72 board certified urologists and 19 novices completed a pre-task questionnaire, viewed an introductory training video and performed a pre-compiled 5-minute resection task. The simulator logged operative errors, gm resected, blood loss, irrigant volume, foot pedal use and differential time spent with orientation, cutting or coagulation. Trainees and experts evaluated the simulator on a modified likert scale. The 2-tailed Levene t test was used to compare means between experts and novices.
Overall version 1.0 content was between slightly and moderately acceptable. Experts spent less time with orientation (p < 0.0001), resected more total tissue (p < 0.0001), had more gm resected per cut (p = 0.002) and less blood loss per gm resected (p = 0.032), used less irrigant per gm resected (p = 0.02) and performed fewer errors (p < 0.0001) than novices.
We established the face, content and construct validity for version 1.0 of the University of Washington TURP trainer to simulate the skills necessary to perform TURP. A predictive validity study showing a translation of skills from the virtual environment to the operating room will complete the validation of this model.
我们对华盛顿大学经尿道前列腺切除术(TURP)训练器1.0版本的外观、内容及结构效度进行了研究。
我们实验室开发了一款基于虚拟现实的经尿道技能模拟器1.0版本,将TURP硬件与虚拟三维解剖结构、冲洗控制、切割、出血及触觉力反馈相结合。共有72名获得委员会认证的泌尿科医生和19名新手完成了任务前问卷,观看了入门培训视频,并执行了一个预先编制的5分钟切除任务。模拟器记录了手术错误、切除的克数、失血量、冲洗液量、脚踏板使用情况以及在定位、切割或凝血上花费的不同时间。学员和专家采用改良的李克特量表对模拟器进行评估。采用双尾Levene t检验比较专家和新手之间的均值。
总体而言,1.0版本的内容在轻微可接受至中等可接受之间。与新手相比,专家在定位上花费的时间更少(p < 0.0001),切除的组织总量更多(p < 0.0001),每次切割切除的克数更多(p = 0.002),每切除一克组织的失血量更少(p = 0.032),每切除一克组织使用的冲洗液更少(p = 0.02),且执行的错误更少(p < 0.0001)。
我们确立了华盛顿大学TURP训练器1.0版本的外观、内容及结构效度,以模拟进行TURP所需的技能。一项显示技能从虚拟环境转化到手术室的预测效度研究将完成该模型的验证。