虚拟现实模拟经皮肾镜取石术培训的验证。
Validation of virtual reality simulation for percutaneous renal access training.
机构信息
Department of Urology, Muljibhai Patel Urological Hospital, Nadiad, India.
出版信息
J Endourol. 2010 Apr;24(4):635-40. doi: 10.1089/end.2009.0166.
OBJECTIVE
The objective of this study was to assess the face, content, construct, convergent, and predictive validities of virtual reality-based simulator in acquisition of skills for percutaneous renal access.
MATERIALS AND METHODS
A cohort of 24 participants comprising novices (n = 15) and experts (n = 9) performed a specific task of percutaneous renal puncture using the same case scenario on PERC Mentor. All objective parameters were stored and analyzed to establish construct validity. Face and content validities were assessed by having all experts fill a standardized questionnaire. All novices underwent further repetition of the same task six times. The first three were unsupervised (pretest) and the later three after the PERC Mentor training (posttest) to establish convergent validity. A subset of five novice cohorts performed percutaneous renal access in an anesthetized pig before and after the training on PERC Mentor to assess the predictive validity. Statistical analysis was done using Student's t-test (p <or= 0.05 statistically significant).
RESULTS
The overall useful appraisal was 4 in a scale of 1 to 5 (1 is poor and 5 is excellent). Experts were significantly faster in total performance time 187 +/- 26 versus 222 +/- 29.6 seconds (p < 0.005) and required fewer attempts to access 2.00 +/- 0.20 versus 2.8 +/- 0.4 (p < 0.001), respectively. The posttest values for the trained novice group showed marked improvement with respect to pretest values in total performance time 42.7 +/- 6.8 versus 222 +/- 29.6 seconds (p < 0.001), fluoroscopy time 66.9 +/- 10.20 versus 123.3 +/- 19.40 seconds (p < 0.0001), decreasing number of perforation 0.8 +/- 0.3 versus 1.3 +/- 0.2 (p < 0.001), and number of attempts to access 1.3 +/- 0.10 versus 2.00 +/- 0.20 (p < 0.001), respectively. Access without complication was attained by all five when compared with one with three complications (baseline vs. posttraining group, respectively) in the porcine model.
CONCLUSION
All aspects of validity were demonstrated on virtual reality-based simulator for percutaneous renal access.
目的
本研究旨在评估基于虚拟现实的模拟器在经皮肾穿刺技能获取中的表面效度、内容效度、结构效度、收敛效度和预测效度。
材料和方法
本研究纳入了一组 24 名参与者，包括新手（n=15）和专家（n=9）。所有参与者都使用 PERC Mentor 进行相同的经皮肾穿刺案例场景下的特定任务。存储并分析所有的客观参数以建立结构效度。通过让所有专家填写标准化问卷来评估表面效度和内容效度。所有新手在进行 6 次相同任务的重复时，前 3 次是无监督的（预测试），后 3 次是在 PERC Mentor 培训后（后测试），以建立收敛效度。五个新手组的子集在 PERC Mentor 培训前后在麻醉猪身上进行经皮肾穿刺，以评估预测效度。使用 Student's t 检验（p<0.05 为统计学显著）进行统计分析。
结果
总体评估为 1 到 5 分制的 4 分（1 分表示差，5 分表示优）。专家在总操作时间上明显更快，分别为 187 +/- 26 秒和 222 +/- 29.6 秒（p<0.005），且需要尝试的次数更少，分别为 2.00 +/- 0.20 次和 2.8 +/- 0.4 次（p<0.001）。接受培训的新手组在后测试中的值与预测试相比有显著改善，总操作时间分别为 42.7 +/- 6.8 秒和 222 +/- 29.6 秒（p<0.001），透视时间分别为 66.9 +/- 10.20 秒和 123.3 +/- 19.40 秒（p<0.0001），穿孔次数分别为 0.8 +/- 0.3 次和 1.3 +/- 0.2 次（p<0.001），尝试次数分别为 1.3 +/- 0.10 次和 2.00 +/- 0.20 次（p<0.001）。在猪模型中，与基线相比，所有新手都成功完成了经皮肾穿刺，没有并发症，而有 3 名新手出现了并发症。
结论
经皮肾穿刺的基于虚拟现实的模拟器在各个方面都表现出了有效性。
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