Department of Applied Physiology and Wellness, Center for Global Health Impact, Simmons School of Education and Human Development, Southern Methodist University, Dallas, TX.
Department of Anthropology, Dedman College of Humanities and Sciences, Southern Methodist University, Dallas, TX.
JCO Glob Oncol. 2021 Mar;7:435-442. doi: 10.1200/GO.20.00510.
Limited access to adequate cancer surgery training is one of the driving forces behind global inequities in surgical cancer care. Affordable virtual reality (VR) surgical training could enhance surgical skills in low- and middle-income settings, but most VR and augmented reality systems are too expensive and do not teach open surgical techniques commonly practiced in these contexts. New low-cost VR can offer skill development simulations relevant to these settings, but little is known about how knowledge is gained and applied by surgeons training and working in specific resource-constrained settings. This study addresses this gap, exploring gynecologic oncology trainee learning and user experience using a low-cost VR simulator to learn to perform an open radical abdominal hysterectomy in Lusaka, Zambia.
Eleven surgical trainees rotating through the gynecologic oncology service were sequentially recruited from the University Teaching Hospital in Lusaka to participate in a study evaluating a VR radical abdominal hysterectomy training designed to replicate the experience in a Zambian hospital. Six participated in semi-structured interviews following the training. Interviews were analyzed using open and axial coding, informed by grounded theory.
Simulator participation increased participants' perception of their surgical knowledge, confidence, and skills. Participants believed their skills transferred to other related surgical procedures. Having clear goals and motivation to improve were described as factors that influenced success.
For cancer surgery trainees in lower-resourced settings learning medical and surgical skills, even for those with limited VR experience, low-cost VR simulators may enhance anatomical knowledge and confidence. The VR simulator reinforced anatomical and clinical knowledge acquired through other modalities. VR-enhanced learning may be particularly valuable when mentored learning opportunities are limited.
获得充分癌症手术培训的机会有限，是全球癌症手术护理存在不平等现象的主要原因之一。负担得起的虚拟现实（VR）手术培训可以提高中低收入环境中的手术技能，但大多数 VR 和增强现实系统过于昂贵，并且无法教授这些环境中常用的开放式手术技术。新的低成本 VR 可以提供与这些环境相关的技能发展模拟，但对于在特定资源受限环境中培训和工作的外科医生如何获得和应用知识，知之甚少。本研究探讨了这一差距，探索了妇科肿瘤学受训者使用低成本 VR 模拟器学习在赞比亚卢萨卡进行开放式根治性腹部子宫切除术的学习和用户体验。
从卢萨卡大学教学医院连续招募了 11 名参加妇科肿瘤学服务轮转的外科受训者，参与一项评估 VR 根治性腹部子宫切除术培训的研究，旨在复制赞比亚医院的经验。6 名参与者在培训后接受了半结构化访谈。访谈分析采用开放式和轴向编码，并以扎根理论为指导。
模拟器参与增加了参与者对其手术知识、信心和技能的感知。参与者认为他们的技能可以转移到其他相关的手术程序中。有明确的目标和提高技能的动机被描述为影响成功的因素。
对于在资源较少的环境中学习医学和手术技能的癌症手术受训者，即使他们的 VR 经验有限，低成本 VR 模拟器也可能增强解剖学知识和信心。VR 模拟器增强了通过其他方式获得的解剖学和临床知识。当指导学习机会有限时，VR 增强学习可能特别有价值。
