Vera Angelina M, Russo Michael, Mohsin Adnan, Tsuda Shawn
University of Nevada School of Medicine, Las Vegas, NV, USA,
Surg Endosc. 2014 Dec;28(12):3467-72. doi: 10.1007/s00464-014-3625-4. Epub 2014 Jun 25.
Laparoscopic skills training has evolved over recent years. However, conveying a mentor's directions using conventional methods, without realistic on-screen visual cues, can be difficult and confusing. To facilitate laparoscopic skill transference, an augmented reality telementoring (ART) platform was designed to overlay the instruments of a mentor onto the trainee's laparoscopic monitor. The aim of this study was to compare the effectiveness of this new teaching modality to traditional methods in novices performing an intracorporeal suturing task.
Nineteen pre-medical and medical students were randomized into traditional mentoring (n = 9) and ART (n = 10) groups for a laparoscopic suturing and knot-tying task. Subjects received either traditional mentoring or ART for 1 h on the validated fundamentals of laparoscopic surgery intracorporeal suturing task. Tasks for suturing were recorded and scored for time and errors. Results were analyzed using means, standard deviation, power regression analysis, correlation coefficient, analysis of variance, and student's t test.
Using Wright's cumulative average model (Y = aX (b)) the learning curve slope was significantly steeper, demonstrating faster skill acquisition, for the ART group (b = -0.567, r (2) = 0.92) than the control group (b = -0.453, r (2) = 0.74). At the end of 10 repetitions or 1 h of practice, the ART group was faster versus traditional (mean 167.4 vs. 242.4 s, p = 0.014). The ART group also had fewer fails (8) than the traditional group (13).
The ART Platform may be a more effective training technique in teaching laparoscopic skills to novices compared to traditional methods. ART conferred a shorter learning curve, which was more pronounced in the first 4 trials. ART reduced the number of failed attempts and resulted in faster suture times by the end of the training session. ART may be a more effective training tool in laparoscopic surgical training for complex tasks than traditional methods.
近年来,腹腔镜技术培训不断发展。然而,使用传统方法传达指导教师的指示,而没有逼真的屏幕视觉提示,可能会困难且令人困惑。为了促进腹腔镜技术的传授,设计了一种增强现实远程指导(ART)平台,将指导教师的器械叠加到学员的腹腔镜监视器上。本研究的目的是比较这种新的教学模式与传统方法在新手进行体内缝合任务时的有效性。
19名医学预科生和医学生被随机分为传统指导组(n = 9)和ART组(n = 10),进行腹腔镜缝合和打结任务。受试者在经过验证的腹腔镜手术体内缝合任务基本原理上接受1小时的传统指导或ART指导。记录缝合任务的时间和错误并进行评分。使用均值、标准差、幂回归分析、相关系数、方差分析和学生t检验对结果进行分析。
使用赖特累积平均模型(Y = aX (b)),ART组(b = -0.567,r (2) = 0.92)的学习曲线斜率比对照组(b = -0.453,r (2) = 0.74)明显更陡,表明技能获取更快。在10次重复或1小时的练习结束时,ART组比传统组更快(平均167.4秒对242.4秒,p = 0.014)。ART组的失败次数(8次)也比传统组(13次)少。
与传统方法相比,ART平台在向新手教授腹腔镜技术方面可能是一种更有效的培训技术。ART带来了更短的学习曲线,在前4次试验中更为明显。ART减少了失败尝试的次数,并在训练结束时缩短了缝合时间。在腹腔镜手术培训中,对于复杂任务,ART可能是比传统方法更有效的培训工具。