Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
World J Surg. 2013 May;37(5):965-73. doi: 10.1007/s00268-013-1963-3.
The purpose of the present study was to determine the value of virtual reality (VR) training for a multimodality training program of basic laparoscopic surgery.
Participants in a two-day multimodality training for laparoscopic surgery used box trainers, live animal training, and cadaveric training on the pulsating organ perfusion (POP) trainer in a structured and standardized training program. The participants were divided into two groups. The VR group (n = 13) also practiced with VR training during the program, whereas the control group (n = 14) did not use VR training. The training modalities were assessed using questionnaires with a five-point Likert scale after the program. Concerning VR training, members of the control group assessed their expectations, whereas the VR group assessed the actual experience of using it. Skills performance was evaluated with five standardized test tasks in a live porcine model before (pre-test) and after (post-test) the training program. Laparoscopic skills were measured by task completion time and a general performance score for each task. Baseline tests were compared with laparoscopic experience of all participants for construct validity of the skills test.
The expected benefit from VR training of the control group was higher than the experienced benefit of the VR group. Box and POP training received better ratings from the VR group than from the control group for some purposes. Both groups improved their skill parameters significantly from pre-training to post-training tests [score +17 % (P < 0.01), time -29 % (P < 0.01)]. No significant difference was found between the two groups for laparoscopic skills improvement except for the score in the instrument coordination task. Construct validity of the skills test was significant for both time and score.
At its current level of performance, VR training does not meet expectations. No additional benefit was observed from VR training in our multimodality training program.
本研究旨在探讨虚拟现实（VR）训练在基础腹腔镜手术多模态培训项目中的价值。
参加为期两天的腹腔镜手术多模态培训的学员在结构化和标准化培训计划中使用盒式训练器、活体动物训练和脉动器官灌注（POP）训练器进行训练。学员被分为两组。VR 组（n = 13）还在培训过程中使用 VR 训练，而对照组（n = 14）则不使用 VR 训练。培训方式采用五点 Likert 量表的问卷进行评估。关于 VR 训练，对照组的成员评估了他们的期望，而 VR 组评估了他们实际使用的经验。在培训计划之前（预测试）和之后（后测试），在活体猪模型中使用五个标准化测试任务评估技能表现。腹腔镜技能通过完成任务的时间和每个任务的总体表现评分来衡量。基础测试与所有参与者的腹腔镜经验进行比较，以验证技能测试的结构效度。
对照组对 VR 训练的预期收益高于 VR 组的实际收益。对于某些目的，VR 组对盒式和 POP 训练的评价高于对照组。两组的技能参数从培训前测试到培训后测试都有显著提高[评分提高 17 %（P < 0.01），时间缩短 29 %（P < 0.01）]。两组在腹腔镜技能提高方面没有显著差异，除了器械协调任务的得分。技能测试的结构效度在时间和得分方面均具有统计学意义。
在目前的表现水平下，VR 训练未达到预期效果。在我们的多模态培训计划中，VR 训练没有观察到额外的益处。
