Stefanidis Dimitrios, Scott Daniel J, Korndorffer James R
Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
Simul Healthc. 2009 Summer;4(2):104-8. doi: 10.1097/SIH.0b013e31819171ec.
The purpose of this study was to compare the added value of motion metrics in determining training completion during a proficiency-based simulator curriculum compared with traditional metrics (time).
Novices (n=16) practiced on a basic laparoscopic task of a hybrid simulator until expert-derived proficiency levels for time, path length, and smoothness were achieved on two consecutive attempts. The order by which proficiency in each metric was achieved was recorded and correlated to baseline characteristics. Motion metrics were considered valuable if their incorporation led to extension of training duration.
Compared with baseline participant performance improved at training completion according to all metrics (time 67+/-17 to 20+/-6 seconds; P<0.001, pathlength 5326+/-1444 to 2339+/-545 cm; P<0.001, and smoothness from 529+/-185 to 133+/-59; P<0.001). Pathlength was the easiest metric to reach the proficiency level and time the most difficult. Four (33%) participants benefited from the motion metrics as their training was prolonged by an average of 50% compared with using time alone. Baseline characteristics did not correlate to the order of achievement of these metrics.
Time may be superior to motion tracking metrics for performance assessment during proficiency-based simulator training. Nevertheless, in this study one third of trainees benefited from motion analysis metrics by having their training duration extended. Further study is needed to establish the value of motion metrics during simulator training and their impact on operating room performance improvement.
本研究的目的是比较在基于熟练度的模拟器课程中，运动指标与传统指标（时间）在确定训练完成情况方面的附加价值。
新手（n = 16）在混合模拟器的基本腹腔镜任务上进行练习，直到在连续两次尝试中达到专家确定的时间、路径长度和流畅度的熟练水平。记录达到每个指标熟练程度的顺序，并将其与基线特征相关联。如果纳入运动指标能延长训练时间，则认为其具有价值。
与基线相比，训练完成时所有指标的参与者表现均有所改善（时间从67±17秒降至20±6秒；P<0.001，路径长度从5326±1444厘米降至2339±545厘米；P<0.001，流畅度从529±185降至133±59；P<0.001）。路径长度是最容易达到熟练水平的指标，而时间是最难的。四名（33%）参与者受益于运动指标，因为与仅使用时间相比，他们的训练平均延长了50%。基线特征与这些指标的达成顺序无关。
在基于熟练度的模拟器训练中，时间在性能评估方面可能优于运动跟踪指标。然而，在本研究中，三分之一的受训者受益于运动分析指标，因为他们的训练时间延长了。需要进一步研究以确定模拟器训练期间运动指标的价值及其对手术室性能改善的影响。
