Medical Physics Lab-Simulation Centre, University of Athens Medical School, Greece.
Acad Emerg Med. 2010 Oct;17(10):1142-5. doi: 10.1111/j.1553-2712.2010.00876.x.
Although virtual reality (VR) simulators play an important role in modern medical training, their efficacy is not often evaluated using learning curves. In this study, the learning curves of novice and intermediate users were elicited during a VR simulation-based curriculum for intravenous (IV) cannulation.
This was a prospective observational study of subjects undergoing training using a VR model of IV cannulation. Participants were divided into two groups: novices (third-year medical students with no prior practical experience in IV catheterization) and intermediates (recent graduates with limited experience). Performance was measured with two endpoints: time to completion and errors committed. Errors were categorized as critical or noncritical. Learning curves (error score and time completion vs. session number) were analyzed using the Friedman's test. Performance before and after training was compared using the Kruskal-Wallis test. The Spearman rank correlation coefficient (r(s)) was used to determine the correlation between time completion and error score estimates. The number of attempts required to complete the training phase was also measured and compared between the two groups.
Thirty subjects were enrolled: 17 in the novice group and 13 in the intermediate group. Learning curve plateaus of intermediates were reached in the sixth case scenario (session), whereas novices reached a plateau in the eighth session. Performance comparison of time to completion and errors showed significant improvement for both groups. Less time and fewer attempts were required by all trainees to complete a scenario while progressing through the curriculum. The overall number of IV cannulation attempts of novices was significantly higher than that of the intermediates throughout the course.
Significant learning curves for novice and intermediate students were demonstrated after following the VR simulation-based curriculum. Competencies acquired during this educational course may provide an important advantage for training prior to actual clinical practice.
尽管虚拟现实 (VR) 模拟器在现代医学培训中发挥着重要作用，但它们的效果并不经常通过学习曲线来评估。在这项研究中，我们在基于 VR 的静脉 (IV) 置管模拟课程中引出了新手和中级用户的学习曲线。
这是一项对接受 IV 置管 VR 模型培训的受试者进行的前瞻性观察研究。参与者分为两组：新手（无 IV 导管插入术实践经验的三年级医学生）和中级（经验有限的应届毕业生）。表现通过两个终点来衡量：完成时间和犯的错误。错误分为关键错误和非关键错误。使用 Friedman 检验分析学习曲线（错误分数和完成时间与会话数的关系）。使用 Kruskal-Wallis 检验比较培训前后的表现。使用 Spearman 秩相关系数（r(s)）确定完成时间和错误分数估计之间的相关性。还测量并比较了两组完成培训阶段所需的尝试次数。
共纳入 30 名受试者：新手组 17 名，中级组 13 名。中级组在第六个病例情景（会话）中达到学习曲线的平台期，而新手组在第八个会话中达到平台期。时间完成和错误的表现比较显示两组均有显著改善。随着课程的进展，所有学员完成一个场景所需的时间和尝试次数都减少了。整个课程中，新手的 IV 置管尝试总数明显高于中级组。
在遵循基于 VR 的模拟课程后，新手和中级学生的学习曲线显著。在实际临床实践之前，通过这种教育课程获得的技能可能会为培训提供重要优势。
