Clark Anna D, Barone Damiano G, Candy Nicholas, Guilfoyle Mathew, Budohoski Karol, Hofmann Riikka, Santarius Thomas, Kirollos Ramez, Trivedi Rikin A
School of Clinical Medicine, University of Cambridge, Hills Road, Cambridge CB2 0SP, United Kingdom.
Department of Clinical Neurosciences, University of Cambridge, Hills Road, Cambridge, CB2 0QQ, United Kingdom; Division of Neurosurgery, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom.
J Surg Educ. 2017 Sep-Oct;74(5):828-836. doi: 10.1016/j.jsurg.2017.02.007. Epub 2017 Mar 22.
In recent years, 3-dimensional (3D) simulation of neurosurgical procedures has become increasingly popular as an addition to training programmes. However, there remains little objective evidence of its effectiveness in improving live surgical skill. This review analysed the current literature in 3D neurosurgical simulation, highlighting remaining gaps in the evidence base for improvement in surgical performance and suggests useful future research directions.
An electronic search of the databases was conducted to identify studies investigating 3D virtual reality (VR) simulation for various types of neurosurgery. Eligible studies were those that used a combination of metrics to measure neurosurgical skill acquisition on a simulation trainer. Studies were excluded if they did not measure skill acquisition against a set of metrics or if they assessed skills that were not used in neurosurgical practice. This was not a systematic review however, the data extracted was tabulated to allow comparison between studies RESULTS: This study revealed that the average overall quality of the included studies was moderate. Only one study assessed outcomes in live surgery, while most other studies assessed outcomes on a simulator using a variety of metrics.
It is concluded that in its current state, the evidence for 3D simulation suggests it as a useful supplement to training programmes but more evidence is needed of improvement in surgical performance to warrant large-scale investment in this technology.
近年来,神经外科手术的三维(3D)模拟作为培训项目的补充手段越来越受欢迎。然而,关于其在提高实际手术技能方面有效性的客观证据仍然很少。本综述分析了当前3D神经外科模拟的文献,突出了在提高手术表现的证据基础方面仍存在的差距,并提出了未来有用的研究方向。
对数据库进行电子检索,以识别研究各种类型神经外科手术的3D虚拟现实(VR)模拟的研究。符合条件的研究是那些使用多种指标组合在模拟训练器上测量神经外科技能获得情况的研究。如果研究没有根据一组指标测量技能获得情况,或者评估的技能在神经外科实践中未被使用,则将其排除。这不是一项系统综述,但是将提取的数据制成表格以便进行研究间的比较。结果:本研究表明,纳入研究的平均整体质量中等。只有一项研究评估了实际手术中的结果,而大多数其他研究使用各种指标在模拟器上评估结果。
得出的结论是,就其目前的状态而言,3D模拟的证据表明它是培训项目的有用补充,但需要更多关于手术表现改善的证据,以保证对该技术进行大规模投资。