University of Toronto, Toronto, Ontario, Canada.
Surgery. 2012 Mar;151(3):391-7. doi: 10.1016/j.surg.2011.08.005. Epub 2011 Oct 22.
Although task training on virtual reality (VR) simulators has been shown to transfer to the operating room, to date no VR curricula have been described for advanced laparoscopic procedures. The purpose of this study was to develop a proficiency-based VR technical skills curriculum for laparoscopic colorectal surgery.
The Delphi method was used to determine expert consensus on which VR tasks (on the LapSim simulator) are relevant to teaching laparoscopic colorectal surgery. To accomplish this task, 19 international experts rated all the LapSim tasks on a Likert scale (1-5) with respect to the degree to which they thought that a particular task should be included in a final technical skills curriculum. Results of the survey were sent back to participants until consensus (Cronbach's α >0.8) was reached. A cross-sectional design was utilized to define the benchmark scores for the identified tasks. Nine expert surgeons completed all identified tasks on the "easy," "medium," and "hard" settings of the simulator.
In the first round of the survey, Cronbach's α was 0.715; after the second round, consensus was reached at 0.865. Consensus was reached for 7 basic tasks and 1 advanced suturing task. Median expert time and economy of movement scores were defined as benchmarks for all curricular tasks.
This study used Delphi consensus methodology to create a curriculum for an advanced laparoscopic procedure that is reflective of current clinical practice on an international level and conforms to current educational standards of proficiency-based training.
虽然虚拟现实 (VR) 模拟器上的任务训练已被证明可转移到手术室，但迄今为止，尚无针对高级腹腔镜手术的 VR 课程。本研究旨在为腹腔镜结直肠手术开发基于熟练度的 VR 技术技能课程。
采用德尔菲法确定专家对哪些 VR 任务（在 LapSim 模拟器上）与腹腔镜结直肠手术教学相关的共识。为了完成这项任务，19 名国际专家对 LapSim 上的所有任务进行了李克特量表（1-5）评分，以确定他们认为某项任务是否应包含在最终的技术技能课程中。调查结果被寄回给参与者，直到达成共识（Cronbach's α>0.8）。采用横断面设计来确定已确定任务的基准分数。9 名专家外科医生在模拟器的“简单”、“中等”和“困难”设置下完成了所有已确定的任务。
在第一轮调查中，Cronbach's α 为 0.715；在第二轮之后，达成了 0.865 的共识。达成共识的有 7 项基本任务和 1 项高级缝合任务。专家的中位数时间和运动效率得分被定义为所有课程任务的基准。
本研究使用德尔菲共识方法为高级腹腔镜手术创建了一个课程，该课程反映了国际水平上的当前临床实践，并符合基于熟练度的培训的当前教育标准。
