Centre for Image Guided Innovation and Therapeutic Intervention (CIGITI), The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Neuro-surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Oper Neurosurg (Hagerstown). 2017 Feb 1;13(1):89-95. doi: 10.1227/NEU.0000000000001317.
The relative educational benefits of virtual reality (VR) and physical simulation models for endoscopic third ventriculostomy (ETV) have not been evaluated "head to head."
To compare and identify the relative utility of a physical and VR ETV simulation model for use in neurosurgical training.
Twenty-three neurosurgical residents and 3 fellows performed an ETV on both a physical and VR simulation model. Trainees rated the models using 5-point Likert scales evaluating the domains of anatomy, instrument handling, procedural content, and the overall fidelity of the simulation. Paired t tests were performed for each domain's mean overall score and individual items.
The VR model has relative benefits compared with the physical model with respect to realistic representation of intraventricular anatomy at the foramen of Monro (4.5, standard deviation [SD] = 0.7 vs 4.1, SD = 0.6; P = .04) and the third ventricle floor (4.4, SD = 0.6 vs 4.0, SD = 0.9; P = .03), although the overall anatomy score was similar (4.2, SD = 0.6 vs 4.0, SD = 0.6; P = .11). For overall instrument handling and procedural content, the physical simulator outperformed the VR model (3.7, SD = 0.8 vs 4.5; SD = 0.5, P < .001 and 3.9; SD = 0.8 vs 4.2, SD = 0.6; P = .02, respectively). Overall task fidelity across the 2 simulators was not perceived as significantly different.
Simulation model selection should be based on educational objectives. Training focused on learning anatomy or decision-making for anatomic cues may be aided with the VR simulation model. A focus on developing manual dexterity and technical skills using endoscopic equipment in the operating room may be better learned on the physical simulation model.
虚拟现实（VR）和物理模拟模型在神经内镜第三脑室造瘘术（ETV）中的相对教育优势尚未进行“面对面”评估。
比较和确定物理和 VR ETV 模拟模型在神经外科培训中的相对效用。
23 名神经外科住院医师和 3 名研究员在物理和 VR 模拟模型上均进行了 ETV。学员使用 5 分制 Likert 量表对模型进行评估，评估领域包括解剖学、器械操作、手术内容和模拟的整体逼真度。对每个领域的总体评分和个别项目进行配对 t 检验。
与物理模型相比，VR 模型在模拟经孟氏孔（4.5，标准差[SD]=0.7 对 4.1，SD=0.6；P=0.04）和第三脑室底部（4.4，SD=0.6 对 4.0，SD=0.9；P=0.03）的脑室解剖结构方面具有相对优势，尽管整体解剖评分相似（4.2，SD=0.6 对 4.0，SD=0.6；P=0.11）。在整体器械操作和手术内容方面，物理模拟器的表现优于 VR 模型（3.7，SD=0.8 对 4.5；SD=0.5，P<0.001 和 3.9，SD=0.8 对 4.2，SD=0.6；P=0.02）。在这 2 种模拟器中，整体任务保真度并未被认为存在显著差异。
模拟模型的选择应基于教育目标。对于以解剖学为重点的学习或解剖学线索的决策，使用 VR 模拟模型可能会有所帮助。在手术室中使用内镜设备提高手动灵巧性和技术技能的重点可能在物理模拟模型上更好地学习。
