Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
Department of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Surg Endosc. 2017 Oct;31(10):4058-4066. doi: 10.1007/s00464-017-5452-x. Epub 2017 Mar 9.
Touch Surgery (TS) is a serious gaming application for cognitive task simulation and rehearsal of key steps in surgical procedures. The aim was to establish face, content, and construct validity of TS for laparoscopic cholecystectomy (LC). Furthermore, learning curves with TS and a virtual reality (VR) trainer were compared in a randomized trial.
The performance of medical students and general surgeons was compared for all three modules of LC in TS to establish construct validity. Questionnaires assessed face and content validity. For analysis of learning curves, students were randomized to train on VR or TS first, and then switched to the other training modality. Performance data were recorded.
54 Surgeons and 51 medical students completed the validation study. Surgeons outperformed students with TS: patient preparation (students = 45.0 ± 19.1%; surgeons = 57.3 ± 15.2%; p < 0.001), access and laparoscopy (students = 70.2 ± 10.9%; surgeons = 75.9 ± 9.7%; p = 0.008) and LC (students = 69.8 ± 12.4%; surgeons = 77.7 ± 9.6%; p < 0.001). Both groups agreed that TS was a highly useful and realistic application. 46 students were randomized for learning curve analysis. It took them 2-4 attempts to reach a 100% score with TS. Training with TS first did not improve students' performance on the VR trainer; however, students who trained with VR first scored significantly higher in module 3 of TS.
TS is an accepted serious gaming application for learning cognitive aspects of LC with established construct, face, and content validity. There appeared to be a synergy between TS and the VR trainer. Therefore, the two training modalities should accompany one another in a multimodal training approach to laparoscopy.
Touch Surgery（TS）是一款用于认知任务模拟和手术步骤关键环节演练的严肃游戏应用。其目的是为腹腔镜胆囊切除术（LC）建立 TS 的表面效度、内容效度和结构效度。此外，还通过一项随机试验比较了 TS 和虚拟现实（VR）训练器的学习曲线。
比较了医学生和普通外科医生在 TS 中 LC 的所有三个模块的表现，以建立结构效度。问卷调查评估了表面效度和内容效度。为了分析学习曲线，学生被随机分配到 VR 或 TS 进行初始训练，然后切换到另一种训练模式。记录了性能数据。
54 名外科医生和 51 名医学生完成了验证研究。外科医生在 TS 中的表现优于学生：患者准备（学生=45.0±19.1%；外科医生=57.3±15.2%；p<0.001）、进入和腹腔镜（学生=70.2±10.9%；外科医生=75.9±9.7%；p=0.008）和 LC（学生=69.8±12.4%；外科医生=77.7±9.6%；p<0.001）。两组都认为 TS 是一种非常有用和逼真的应用。46 名学生被随机分配进行学习曲线分析。他们需要 2-4 次尝试才能达到 TS 的 100%得分。首先进行 TS 训练并没有提高学生在 VR 训练器上的表现；然而，先进行 VR 训练的学生在 TS 的第 3 模块中得分显著更高。
TS 是一种被接受的严肃游戏应用，用于学习 LC 的认知方面，具有既定的结构、表面和内容效度。TS 和 VR 训练器之间似乎存在协同作用。因此，在腹腔镜培训的多模态方法中，两种培训方式应该相互配合。
