埃因霍温腹腔镜胆囊切除术培训课程——使用虚拟现实培训提高手术室表现:首个欧洲内镜外科学会认可的虚拟现实培训课程的结果
The Eindhoven laparoscopic cholecystectomy training course--improving operating room performance using virtual reality training: results from the first E.A.E.S. accredited virtual reality trainings curriculum.
作者信息
Schijven M P, Jakimowicz J J, Broeders I A M J, Tseng L N L
机构信息
IJsselland Hospital, 2900 AR Capelle a/d IJssel, 696, The Netherlands.
出版信息
Surg Endosc. 2005 Sep;19(9):1220-6. doi: 10.1007/s00464-004-2240-1.
BACKGROUND
This study was undertaken to investigate operating room performance of surgical residents, after participating in the Eindhoven virtual reality laparoscopic cholecystectomy training course. This course is the first formal surgical resident trainings course, using a variety of complementary virtual reality (VR) skills training simulation in order to prepare surgical residents for their first laparoscopic cholecystectomy. The course was granted EAES certification.
METHODS
The four-day course is based on multimedia and multimodality approach. A variety of increasingly difficult simulation training sessions, next to intimate focus-group "knowledge sessions" are included. Both basic and procedural VR simulation is featured, using MIST-VR and the Xitacts' LapChol simulation software. The operating room performance of twelve surgical residents who participated in the course and twelve case-control counterparts were compared. The case-control group was matched for clinical number laparoscopic cholecystectomy performance (maximum of 4 procedures). Two observers analyzed a randomly mixed videotape, featuring the part of the "clip-and-cut" procedure of the laparoscopic cholecystectomy, and were blinded for participants' group status. Structured questionnaires including multiple observation scales were used to assess performance.
RESULTS
Residents of both the experimental and control group did not differ in demographic parameters, except for number of laparoscopic cholecystectomies in favor of the control group (p-value 0.008). Both observers judge the experimental group to perform significantly better (p-value 0.004 and 0.013). Experimental group residents valued their course highly in terms of their laparoscopic surgical skills improvement and the use of VR simulators in the surgical curriculum.
CONCLUSIONS
The Eindhoven Virtual Reality laparoscopic cholecystectomy training course improves surgical skill in the operating room above the level of residents trained by a variety of other training methods.
背景
本研究旨在调查外科住院医师参加埃因霍温虚拟现实腹腔镜胆囊切除术培训课程后的手术室表现。该课程是首个正式的外科住院医师培训课程,采用多种互补的虚拟现实(VR)技能培训模拟,为外科住院医师的首次腹腔镜胆囊切除术做准备。该课程获得了欧洲内镜外科学会(EAES)认证。
方法
为期四天的课程基于多媒体和多模态方法。除了密切关注的焦点小组“知识课程”外,还包括各种难度逐渐增加的模拟训练课程。课程采用了基本和程序性VR模拟,使用了MIST-VR和Xitacts公司的LapChol模拟软件。比较了参加该课程的12名外科住院医师与12名病例对照者的手术室表现。病例对照组在临床腹腔镜胆囊切除术操作数量上进行匹配(最多4例手术)。两名观察者分析了一盘随机混合的录像带,录像带内容为腹腔镜胆囊切除术“夹闭与切断”操作部分,且对参与者的分组情况不知情。使用包括多个观察量表的结构化问卷来评估表现。
结果
实验组和对照组住院医师在人口统计学参数上没有差异,除了腹腔镜胆囊切除术的数量,对照组更具优势(p值为0.008)。两名观察者均判断实验组表现明显更好(p值分别为0.004和0.013)。实验组住院医师高度评价该课程对他们腹腔镜手术技能的提升以及在外科课程中使用VR模拟器。
结论
埃因霍温虚拟现实腹腔镜胆囊切除术培训课程提高了外科住院医师在手术室的技能,高于通过其他多种培训方法培训的住院医师水平。