Zirkle Molly, Roberson David W, Leuwer Rudolf, Dubrowski Adam
Department of Otolaryngology - Head and Neck Surgery, Wilson Centre for Research in Clinical Education, University of Toronto, Toronto, Ontario, Canada.
Laryngoscope. 2007 Feb;117(2):258-63. doi: 10.1097/01.mlg.0000248246.09498.b4.
The objective of this study is to determine the feasibility of computerized evaluation of resident performance using hand motion analysis on a virtual reality temporal bone (VR TB) simulator. We hypothesized that both computerized analysis and expert ratings would discriminate the performance of novices from experienced trainees. We also hypothesized that performance on the virtual reality temporal bone simulator (VR TB) would differentiate based on previous drilling experience.
The authors conducted a randomized, blind assessment study.
Nineteen volunteers from the Otolaryngology-Head and Neck Surgery training program at the University of Toronto drilled both a cadaveric TB and a simulated VR TB. Expert reviewers were asked to assess operative readiness of the trainee based on a blind video review of their performance. Computerized hand motion analysis of each participant's performance was conducted.
Expert raters were able to discriminate novices from experienced trainees (P < .05) on cadaveric temporal bones, and there was a trend toward discrimination on VR TB performance. Hand motion analysis showed that experienced trainees had better movement economy than novices (P < .05) on the VR TB.
Performance, as measured by hand motion analysis on the VR TB simulator, reflects trainees' previous drilling experience. This study suggests that otolaryngology trainees could accomplish initial temporal bone training on a VR TB simulator, which can provide feedback to the trainee, and may reduce the need for constant faculty supervision and evaluation.
本研究的目的是确定使用虚拟现实颞骨(VR TB)模拟器上的手部动作分析对住院医师表现进行计算机化评估的可行性。我们假设计算机化分析和专家评分都能区分新手和有经验学员的表现。我们还假设虚拟现实颞骨模拟器(VR TB)上的表现会因先前的钻孔经验而有所不同。
作者进行了一项随机、盲法评估研究。
来自多伦多大学耳鼻咽喉头颈外科培训项目的19名志愿者对一具尸体颞骨和一个模拟的VR TB进行钻孔操作。要求专家评审员根据对学员表现的盲法视频回顾来评估其手术准备情况。对每位参与者的表现进行计算机化手部动作分析。
专家评分者能够在尸体颞骨上区分新手和有经验的学员(P <.05),并且在VR TB表现上有区分的趋势。手部动作分析表明,在VR TB上,有经验的学员比新手具有更好的动作经济性(P <.05)。
通过VR TB模拟器上的手部动作分析衡量的表现反映了学员先前的钻孔经验。本研究表明,耳鼻咽喉科住院医师可以在VR TB模拟器上完成初步的颞骨训练,该模拟器可以为学员提供反馈,并可能减少对教师持续监督和评估的需求。