Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, Santiago, Chile.
Department of Surgery, UCSF Fresno, Fresno, CA, USA.
Surg Endosc. 2020 Jun;34(6):2585-2592. doi: 10.1007/s00464-019-07024-1. Epub 2019 Jul 30.
Simulation training is a validated method for acquiring laparoscopic skills. Training sessions may be sporadic or lack continuity in oversight by instructors since traditional programs mandate in-person teaching and evaluation. This study presents the development, implementation, and results of a novel smartphone application that enables remote teacher-student interaction. This interface is used to complete a validated program that provides learner-specific feedback. Outcomes of training via Lapp were compared to outcomes of traditional in-person training.
A web-based and mobile iOS and Android application (Lapp) was developed to enable a remote student-teacher interaction. Instructors use Lapp to assess video recorded training sessions of students at distant locations and guide them through the laparoscopic skill course with specific and personalized feedback. Surgical trainees at two remote training centers were taught using Lapp. A control group was assessed during traditional simulation training at the training facility, with in-person feedback. Pre- and post-training performances were video recorded for each trainee and blindly evaluated by two experts using a global rating scale (GRS) and a specific rating scale (SRS).
A total of 30 trainees were trained via Lapp and compared with 25 locally taught. Performance in the Lapp group improved significantly after the course in both GRS and SRS scores, from 15 [6-17] to 23 [20-25], and from 12 [11-15] to 18 [15-20], respectively. The results between both groups were comparable.
Laparoscopic simulation training using a mobile app is as effective as in-person instruction in teaching advanced laparoscopic surgical skills. Lapp provides an effective method of teaching through simulation remotely and may allow expansion of robust simulation training curriculums.
模拟训练是获取腹腔镜技能的一种经过验证的方法。由于传统课程要求进行面对面的教学和评估，因此培训课程可能是零散的，或者缺乏教师的持续监督。本研究介绍了一种新的智能手机应用程序的开发、实施和结果，该应用程序能够实现远程师生互动。该界面用于完成提供学习者特定反馈的经过验证的计划。通过 Lapp 进行培训的结果与传统面对面培训的结果进行了比较。
开发了一个基于网络的移动 iOS 和 Android 应用程序（Lapp），以实现远程学生-教师交互。教师使用 Lapp 评估远程地点学生的视频记录培训课程，并使用特定的个性化反馈指导他们完成腹腔镜技能课程。在两个远程培训中心，使用 Lapp 教授外科受训者。在培训设施中，通过传统模拟培训评估对照组，并提供面对面的反馈。每位学员的预培训和培训后表现均进行视频记录，并由两位专家使用综合评分量表（GRS）和特定评分量表（SRS）进行盲法评估。
共有 30 名受训者通过 Lapp 进行培训，并与在本地教授的 25 名受训者进行比较。在课程结束后，Lapp 组的 GRS 和 SRS 评分均显著提高，分别从 15 [6-17]提高到 23 [20-25]和从 12 [11-15]提高到 18 [15-20]。两组之间的结果相当。
使用移动应用程序进行腹腔镜模拟训练与面对面教学在教授高级腹腔镜手术技能方面同样有效。Lapp 提供了一种通过模拟进行远程有效教学的方法，并且可能允许扩展强大的模拟培训课程。
