School of Medical Education, King's College London, London, United Kingdom,
MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom.
Eur Surg Res. 2022;63(1):40-45. doi: 10.1159/000520386. Epub 2021 Nov 1.
OBJECTIVES: The disruption to surgical training and medical education caused by the global COVID-19 pandemic highlighted the need for realistic, reliable, and engaging educational opportunities available outside of the operating theatre and accessible for trainees of all levels. This article presents the design and development of a virtual reality curriculum which simulates the surgical mentorship experience outside of the operating theatre, with a focus on surgical anatomy and surgical decision-making. METHOD: This was a multi-institutional study between London's King's College and Imperial College. The index procedure selected for the module was robotic radical prostatectomy. For each stage of the surgical procedure, subject-matter experts (N = 3) at King's College London, identified (1) the critical surgical-decision making points, (2) critical anatomical landmarks, and (3) tips and techniques for overcoming intraoperative challenges. Content validity was determined by an independent panel of subject-matter experts (N = 8) at Imperial College, London, using Fleiss' kappa statistic. The experts' teaching points were combined with operative footage and illustrative animations, and projected onto a virtual reality headset. The module was piloted to surgical science students (N = 15). Quantitative analysis compared participants' confidence regarding their anatomical knowledge before and after taking the module. Qualitative data were gathered from students regarding their views on using the virtual reality model. RESULTS: Multi-rater agreement between experts was above the 70.0% threshold for all steps of the procedure. Seventy-three percentage of pilot study participants "agreed" or "strongly agreed" that they achieved a better understanding of surgical anatomy and the rationale behind each procedural step. This was reflected in an increase in the median knowledge score after trialing the curriculum (p < 0.001). 100% of subject-matter experts and 93.3% of participants "agreed" or "strongly agreed" that virtual mentorship would be useful for future surgical training. CONCLUSIONS: This study demonstrated that virtual surgical mentorship could be a feasible and cost-effective alternative to traditional training methods with the potential to improve technical skills, such as operative proficiency and nontechnical skills such as decision-making and situational judgement.
目的:全球 COVID-19 大流行对外科培训和医学教育造成的干扰突显了在手术室之外提供现实、可靠和引人入胜的教育机会的必要性,让各级学员都能获得这些机会。本文介绍了一种虚拟现实课程的设计和开发,该课程模拟了手术室之外的外科指导经验,重点是外科解剖学和外科决策。
方法:这是伦敦国王学院和帝国理工学院之间的一项多机构研究。该模块选择的索引程序是机器人根治性前列腺切除术。对于手术过程的每一个阶段,伦敦国王学院的专题专家(N=3)确定了(1)关键手术决策点,(2)关键解剖学标志,以及(3)克服术中挑战的技巧和技术。伦敦帝国理工学院的一个独立专题专家小组(N=8)使用 Fleiss'kappa 统计来确定内容效度。专家的教学要点与手术镜头和说明性动画相结合,并投射到虚拟现实耳机上。该模块对 15 名外科科学学生进行了试点。对参与者在参加该模块前后对解剖学知识的信心进行了定量分析。学生们对使用虚拟现实模型的看法收集了定性数据。
结果:所有手术步骤的专家多评分一致性均高于 70.0%的阈值。73%的试点研究参与者“同意”或“强烈同意”他们更好地理解了外科解剖学和每个手术步骤背后的原理。这反映在试用课程后中位数知识得分的增加(p<0.001)。100%的专题专家和 93.3%的参与者“同意”或“强烈同意”虚拟指导将对未来的外科培训有用。
结论:这项研究表明,虚拟外科指导可能是传统培训方法的一种可行且具有成本效益的替代方案,具有提高技术技能(如手术熟练度)和非技术技能(如决策和情境判断)的潜力。
J Surg Educ. 2017-9-30
Khirurgiia (Mosk). 2019
J Robot Surg. 2023-10
J Minim Invasive Gynecol. 2015
Front Med (Lausanne). 2025-7-18
Int J Med Robot. 2023-2