Pulijala Yeshwanth, Ma Minhua, Pears Matthew, Peebles David, Ayoub Ashraf
Doctoral Researcher, School of Art, Design and Architecture, University of Huddersfield, Huddersfield, United Kingdom.
Professor, Computer Games Technology, School of Computing and Digital Technologies, Staffordshire University, Stoke-on-Trent, United Kingdom.
J Oral Maxillofac Surg. 2018 May;76(5):1065-1072. doi: 10.1016/j.joms.2017.10.002. Epub 2017 Oct 13.
Surgical training methods are evolving with the technological advancements, including the application of virtual reality (VR) and augmented reality. However, 28 to 40% of novice residents are not confident in performing a major surgical procedure. VR surgery, an immersive VR (iVR) experience, was developed using Oculus Rift and Leap Motion devices (Leap Motion, Inc, San Francisco, CA) to address this challenge. Our iVR is a multisensory, holistic surgical training application that demonstrates a maxillofacial surgical technique, the Le Fort I osteotomy. The main objective of the present study was to evaluate the effect of using VR surgery on the self-confidence and knowledge of surgical residents.
A multisite, single-blind, parallel, randomized controlled trial (RCT) was performed. The participants were novice surgical residents with limited experience in performing the Le Fort I osteotomy. The primary outcome measures were the self-assessment scores of trainee confidence using a Likert scale and an objective assessment of the cognitive skills. Ninety-five residents from 7 dental schools were included in the RCT. The participants were randomly divided into a study group of 51 residents and a control group of 44. Participants in the study group used the VR surgery application on an Oculus Rift with Leap Motion device. The control group participants used similar content in a standard PowerPoint presentation on a laptop. Repeated measures multivariate analysis of variance was applied to the data to assess the overall effect of the intervention on the confidence of the residents.
The study group participants showed significantly greater perceived self-confidence levels compared with those in the control group (P = .034; α = 0.05). Novices in the first year of their training showed the greatest improvement in their confidence compared with those in their second and third year.
iVR experiences improve the knowledge and self-confidence of the surgical residents.
随着技术进步，手术训练方法不断发展，包括虚拟现实（VR）和增强现实的应用。然而，28%至40%的新手住院医师对进行大型外科手术缺乏信心。为应对这一挑战，利用Oculus Rift和Leap Motion设备（Leap Motion公司，加利福尼亚州旧金山）开发了VR手术，即沉浸式VR（iVR）体验。我们的iVR是一种多感官、整体的外科手术训练应用程序，展示了一种颌面外科技术——勒福Ⅰ型截骨术。本研究的主要目的是评估使用VR手术对外科住院医师自信心和知识的影响。
进行了一项多中心、单盲、平行、随机对照试验（RCT）。参与者为在进行勒福Ⅰ型截骨术方面经验有限的新手外科住院医师。主要结局指标是使用李克特量表对学员自信心的自我评估得分以及对认知技能的客观评估。来自7所牙科学院的95名住院医师被纳入RCT。参与者被随机分为51名住院医师的研究组和44名住院医师的对照组。研究组的参与者使用配备Leap Motion设备的Oculus Rift上的VR手术应用程序。对照组的参与者在笔记本电脑上使用标准PowerPoint演示文稿中的类似内容。对数据应用重复测量多变量方差分析，以评估干预对住院医师自信心的总体影响。
与对照组相比，研究组参与者表现出明显更高的自我感知自信心水平（P = 0.034；α = 0.05）。与第二年和第三年的新手相比，培训第一年的新手自信心提升最大。
iVR体验提高了外科住院医师的知识水平和自信心。
