Lucas Steven, Tuncel Altug, Bensalah Karim, Zeltser Ilia, Jenkins Adam, Pearle Margaret, Cadeddu Jeffrey
University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
J Endourol. 2008 May;22(5):1047-51. doi: 10.1089/end.2007.0366.
With the expanding role of laparoscopy in urologic practice, efficient and safe training has become paramount. Virtual reality simulation may potentially aid training, but it requires validation before it can be incorporated into training programs. The objective of this study was to assess whether training on a virtual reality (VR) laparoscopy simulator (LAP Mentor) can improve performance of virtual laparoscopic procedures.
After a basic introduction to the LAP Mentor, 32 inexperienced medical students performed a baseline VR cholecystectomy that was observed and scored by two observers using the Objective Structured Assessment of Technical Skills (OSATS). The students were then randomized to two groups: Group 1 trained on the simulator without supervision during a total of six 30-minute sessions, and group 2 received no training. Students were then reevaluated on a second VR cholecystectomy by the same observers.
All 32 students completed the study. The two groups were comparable with regard to baseline OSATS scores (group 1, 16.6+/-4.3 v group 2, 15.67+/-6.3, P=0.2). On the second evaluation, the trained students (group 1) performed significantly better than the control group (group 2) (27.9+/-7.2 v 17.6+/-6.2, P<0.001). Group 1 students outperformed group 2 students in each category of the OSATS. Moreover, trained students improved their scores by at least 20% (P<0.001) in each category, while the untrained students improved only in the "knowledge of procedure" category by 25% (P=0.03).
Skills training on a LAP Mentor VR simulator improved VR surgical performance. Before incorporating this simulator into resident education, the LAP Mentor will have to undergo testing for predictive and construct validity.
随着腹腔镜检查在泌尿外科实践中的作用不断扩大，高效且安全的培训变得至关重要。虚拟现实模拟可能有助于培训，但在将其纳入培训项目之前需要进行验证。本研究的目的是评估在虚拟现实（VR）腹腔镜模拟器（LAP Mentor）上的培训是否能提高虚拟腹腔镜手术的操作表现。
在对LAP Mentor进行基本介绍后，32名缺乏经验的医学生进行了一次基线VR胆囊切除术，由两名观察者使用客观结构化技术技能评估（OSATS）进行观察和评分。然后将学生随机分为两组：第1组在总共六个30分钟的课程中在无监督的情况下在模拟器上进行培训，第2组不接受培训。然后由相同的观察者对学生进行第二次VR胆囊切除术的重新评估。
所有32名学生完成了研究。两组在基线OSATS评分方面具有可比性（第1组，16.6±4.3对第2组，15.67±6.3，P = 0.2）。在第二次评估中，接受培训的学生（第1组）的表现明显优于对照组（第2组）（27.9±7.2对17.6±6.2，P <0.001）。第1组学生在OSATS的每个类别中都优于第2组学生。此外，接受培训的学生在每个类别中的分数至少提高了20%（P <0.001），而未接受培训的学生仅在“手术知识”类别中提高了25%（P = 0.03）。
在LAP Mentor VR模拟器上进行技能培训可提高VR手术操作表现。在将该模拟器纳入住院医师教育之前，LAP Mentor必须进行预测效度和结构效度测试。
