Nickel Felix, Brzoska Julia A, Gondan Matthias, Rangnick Henriette M, Chu Jackson, Kenngott Hannes G, Linke Georg R, Kadmon Martina, Fischer Lars, Müller-Stich Beat P
From the Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany (FN, JAB, HMR, JC, HGK, GRL, MK, LF, BPM-S); and Department of Psychology, University of Copenhagen, Copenhagen, Denmark (MG).
Medicine (Baltimore). 2015 May;94(20):e764. doi: 10.1097/MD.0000000000000764.
This study compared virtual reality (VR) training with low cost-blended learning (BL) in a structured training program.Training of laparoscopic skills outside the operating room is mandatory to reduce operative times and risks.Laparoscopy-naïve medical students were randomized in 2 groups stratified for sex. The BL group (n = 42) used E-learning for laparoscopic cholecystectomy (LC) and practiced basic skills with box trainers. The VR group (n = 42) trained basic skills and LC on the LAP Mentor II (Simbionix, Cleveland, OH). Each group trained 3 × 4 hours followed by a knowledge test concerning LC. Blinded raters assessed the operative performance of cadaveric porcine LC using the Objective Structured Assessment of Technical Skills (OSATS). The LC was discontinued when it was not completed within 80 min. Students evaluated their training modality with questionnaires.The VR group completed the LC significantly faster and more often within 80 min than BL (45% v 21%, P = .02). The BL group scored higher than the VR group in the knowledge test (13.3 ± 1.3 vs 11.0 ± 1.7, P < 0.001). Both groups showed equal operative performance of LC in the OSATS score (49.4 ± 10.5 vs 49.7 ± 12.0, P = 0.90). Students generally liked training and felt well prepared for assisting in laparoscopic surgery. The efficiency of the training was judged higher by the VR group than by the BL group.VR and BL can both be applied for training the basics of LC. Multimodality training programs should be developed that combine the advantages of both approaches.
本研究在一个结构化培训项目中，将虚拟现实（VR）培训与低成本混合式学习（BL）进行了比较。在手术室之外进行腹腔镜技能培训对于减少手术时间和风险是必不可少的。未接触过腹腔镜手术的医学生按性别分层随机分为两组。BL组（n = 42）使用电子学习进行腹腔镜胆囊切除术（LC），并使用箱式训练器练习基本技能。VR组（n = 42）在LAP Mentor II（Simbionix，俄亥俄州克利夫兰）上训练基本技能和LC。每组进行3×4小时的训练，随后进行关于LC的知识测试。 blinded评分者使用客观结构化技术技能评估（OSATS）对猪尸体LC的手术操作表现进行评估。如果在80分钟内未完成LC，则停止手术。学生通过问卷评估他们的培训方式。VR组在80分钟内完成LC的速度明显更快，且完成率更高，高于BL组（45%对21%，P = 0.02）。在知识测试中，BL组的得分高于VR组（13.3±1.3对11.0±1.7，P < 0.001）。在OSATS评分中，两组在LC的手术操作表现上相当（49.4±10.5对49.7±12.0，P = 0.90）。学生总体上喜欢培训，并感觉为协助腹腔镜手术做好了充分准备。VR组对培训效率的评价高于BL组。VR和BL都可用于培训LC的基础知识。应开发结合两种方法优点的多模式培训项目。
