Guseila Loredana M, Saranathan Archana, Jenison Eric L, Gil Karen M, Elias John J
Department of Research, Akron General Medical Center, 1 Akron General Avenue, Akron, OH, 44307, USA.
Department of Obstetrics and Gynecology, Akron General Medical Center, Akron, OH, USA.
J Robot Surg. 2014 Sep;8(3):261-8. doi: 10.1007/s11701-014-0465-0. Epub 2014 Apr 29.
Periodic practice is needed for newly trained robotic surgeons to maintain skills during periods of robotic inactivity. The current study was performed to determine whether virtual robotic skill maintenance can serve as an adequate substitute for practice on a surgical robot. Eleven surgical residents with no prior robotic training were trained to a level of robotic proficiency with inanimate models, including a needle driving pad, a running suture pad, and ring placement on a rocking peg board. After reaching proficiency, each resident was tested on a complex tissue closure task. For the next 8 weeks, the only robotic activity was biweekly virtual robotic skills maintenance. After 8 weeks, the residents performed the tissue closure task twice with the robot, followed by evaluation on the inanimate models used to reach proficiency. Repeated-measures statistical analyses were used to compare between the three tissue closure trials and between the final test at week 0 and the evaluation at week 8 for the other inanimate models. Time to complete the tissue closure task was more than 20 % lower for the second evaluation at 8 weeks than for the other two trials (p < 0.05). Residents maintained their skills for needle driving, but times for suture running and rocking peg board increased by more than 20 % at 8 weeks (p < 0.01). Virtual practice shows promise for maintaining robotic skills. Following a warm-up period, some skills may actually improve with biweekly virtual practice, but skill retention is selective, so further improvements are needed.
新培训的机器人外科医生需要定期练习,以便在没有机器人手术的期间保持技能。本研究旨在确定虚拟机器人技能维持是否可以充分替代在手术机器人上的练习。11名之前没有接受过机器人培训的外科住院医师使用无生命模型进行培训,直至达到机器人操作熟练水平,这些模型包括持针垫、连续缝合垫以及在摇摆钉板上放置指环。达到熟练水平后,每位住院医师都要接受一项复杂的组织缝合任务测试。在接下来的8周里,唯一的机器人活动是每两周进行一次虚拟机器人技能维持。8周后,住院医师使用机器人进行两次组织缝合任务,然后使用达到熟练水平时所用的无生命模型进行评估。采用重复测量统计分析来比较三次组织缝合试验之间,以及第0周的最终测试与第8周对其他无生命模型评估之间的差异。8周时第二次评估完成组织缝合任务的时间比其他两次试验低20%以上(p<0.05)。住院医师保持了持针技能,但8周时连续缝合和摇摆钉板的操作时间增加了20%以上(p<0.01)。虚拟练习在维持机器人技能方面显示出前景。经过一段热身期后,每两周进行虚拟练习实际上可能会提高一些技能,但技能保持具有选择性,因此还需要进一步改进。
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