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泌尿外科住院医师在进行活体猪肾切除术和机器人手术虚拟现实训练模块时,经历的工作量情况相当。

Urology residents experience comparable workload profiles when performing live porcine nephrectomies and robotic surgery virtual reality training modules.

作者信息

Mouraviev Vladimir, Klein Martina, Schommer Eric, Thiel David D, Samavedi Srinivas, Kumar Anup, Leveillee Raymond J, Thomas Raju, Pow-Sang Julio M, Su Li-Ming, Mui Engy, Smith Roger, Patel Vipul

机构信息

Global Robotics Institute, Celebration, FL, USA.

Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA.

出版信息

J Robot Surg. 2016 Mar;10(1):49-56. doi: 10.1007/s11701-015-0540-1. Epub 2016 Jan 11.

Abstract

In pursuit of improving the quality of residents' education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The workshop involves performing a robotic live porcine nephrectomy as well as virtual reality robotic training modules. The aim of this study was to evaluate workload levels of urology residents when performing a live porcine nephrectomy and the virtual reality robotic surgery training modules employed during this workshop. Twenty-one residents from 14 SES AUA programs participated in 2015. On the first-day residents were taught with didactic lectures by faculty. On the second day, trainees were divided into two groups. Half were asked to perform training modules of the Mimic da Vinci-Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, USA) for 4 h, while the other half performed nephrectomy procedures on a live porcine model using the da Vinci Si robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). After the first 4 h the groups changed places for another 4-h session. All trainees were asked to complete the NASA-TLX 1-page questionnaire following both the MdVT simulation and live animal model sessions. A significant interface and TLX interaction was observed. The interface by TLX interaction was further analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significant difference was observed for frustration, which was significantly higher at the simulation than the animal model, t (20) = 4.12, p = 0.001. This could be due to trainees' familiarity with live anatomical structures over skill set simulations which remain a real challenge to novice surgeons. Another reason might be that the simulator provides performance metrics for specific performance traits as well as composite scores for entire exercises. Novice trainees experienced substantial mental workload while performing tasks on both the simulator and the live animal model during the robotics course. The NASA-TLX profiles demonstrated that the live animal model and the MdVT were similar in difficulty, as indicated by their comparable workload profiles.

摘要

为了提高住院医师的教育质量,美国泌尿外科学会东南分会(SES AUA)为其住院医师举办了一年一度的机器人培训课程。该研讨会包括进行机器人活体猪肾切除术以及虚拟现实机器人培训模块。本研究的目的是评估泌尿外科住院医师在进行活体猪肾切除术以及该研讨会中使用的虚拟现实机器人手术培训模块时的工作量水平。2015年,来自SES AUA的14个项目的21名住院医师参加了此次培训。第一天,住院医师接受教员的理论讲座。第二天,学员被分成两组。一半学员被要求使用Mimic da Vinci-Trainer(MdVT,Mimic Technologies公司,美国华盛顿州西雅图)进行4小时的培训模块,而另一半学员则使用da Vinci Si机器人(直观外科公司,美国加利福尼亚州森尼韦尔)在活体猪模型上进行肾切除术。前4小时后,两组交换场地进行另外4小时的课程。所有学员在完成MdVT模拟和活体动物模型课程后,都被要求填写1页的NASA-TLX问卷。观察到显著的界面和TLX交互作用。对TLX交互作用的界面进行进一步分析,以确定六个TLX量表中每个量表的得分在两个界面上是否有所不同。在两个界面上观察到的TLX得分均值相似。唯一显著的差异出现在挫折感方面,模拟时的挫折感显著高于动物模型,t(20)=4.12,p=0.001。这可能是由于学员对活体解剖结构比对技能集模拟更熟悉,而技能集模拟对新手外科医生来说仍然是一个真正的挑战。另一个原因可能是模拟器提供了特定性能特征的性能指标以及整个练习的综合得分。在机器人课程中,新手学员在模拟器和活体动物模型上执行任务时都经历了大量的心理工作量。NASA-TLX剖面图表明,活体动物模型和MdVT在难度上相似,这从它们相当的工作量剖面图可以看出。

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