手术视频学习：显微镜、二维和三维内窥镜耳部手术技术的随机比较。
Video Learning of Surgical Procedures: A Randomized Comparison of Microscopic, 2- and 3-Dimensional Endoscopic Ear Surgery Techniques.
机构信息
Department of Psychology, University of Bern.
Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
出版信息
Otol Neurotol. 2022 Aug 1;43(7):e746-e752. doi: 10.1097/MAO.0000000000003550. Epub 2022 Jul 29.
BACKGROUND
Video learning of surgical procedures helps trainees gain an initial understanding of the complex anatomy and the surgical procedure. Because no comparative studies have yet examined which microsurgical approach to the middle ear is most suitable for video learning, the authors investigated objective and subjective outcomes for medical trainees observing microscopic, 2-dimensional (2D) endoscopic, and 3- dimensional (3D) endoscopic ear surgeries.
METHODS
Sixty-two medical students (min. 3rd year) from the University Hospital of Bern watched three standardized videos of a type I tympanoplasty surgery recording, conducted with a microscope, a 2D endoscope, and a 3D endoscope, respectively. The authors measured participants' learning outcome, eye movements, cognitive load, and subjective preferences.
RESULTS
Of the 62 participants included in the study, 14 were male (22.58%), and mean age was 24.44 years (range: 21-29). Learning outcome was highest after watching the 3D endoscopic video (mean [SD], 59.48% [20.57%]). Differences in score were statistically significant: 2D endoscopic video (mean difference: -6.56%, 95% CI: -13.02 to -0.10%), microscopic video (mean difference: -13.82%, 95% CI: -20.27 to -7.36%). Participants showed lowest average eye fixation duration when watching the 3D endoscopic video (mean [SD], 307 ms [109 ms]), with statistically significant differences to the 2D endoscopic video (mean difference: -139 ms, 95% CI: -185 to -93 ms), and the microscopic video (mean difference: -264 ms, 95% CI: -310 to -218 ms). Participants reported lowest cognitive load for the 2D and 3D endoscopic videos. Ratings on discomfort, usability, naturalness, depth perception, and image quality were in favor of the 3D endoscopic video.
CONCLUSION
The 3D endoscopic technique offers many advantages for video learning in terms of knowledge gain, visual field exploration, and subjective evaluation. To optimize learning effects in trainees, the authors recommend the use of endoscopes in middle ear surgery and, if available, using 3D technology.
背景
手术过程的视频学习有助于学员初步了解复杂的解剖结构和手术过程。由于目前还没有比较研究来确定哪种中耳显微镜手术入路最适合视频学习，作者研究了医学学员观察显微镜下、二维（2D）内镜和三维（3D）内镜耳部手术的客观和主观结果。
方法
来自伯尔尼大学医院的 62 名医学学生（至少为三年级）观看了三种标准化的 I 型鼓室成形术录像，分别使用显微镜、2D 内窥镜和 3D 内窥镜进行。作者测量了参与者的学习成果、眼球运动、认知负荷和主观偏好。
结果
在纳入研究的 62 名参与者中，有 14 名男性（22.58%），平均年龄为 24.44 岁（范围：21-29 岁）。观看 3D 内窥镜视频后的学习效果最高（平均[标准差]，59.48%[20.57%]）。评分差异具有统计学意义：2D 内窥镜视频（平均差异：-6.56%，95%CI：-13.02 至-0.10%），显微镜视频（平均差异：-13.82%，95%CI：-20.27 至-7.36%）。参与者在观看 3D 内窥镜视频时的平均眼固定时间最短（平均[标准差]，307 毫秒[109 毫秒]），与 2D 内窥镜视频（平均差异：-139 毫秒，95%CI：-185 至-93 毫秒）和显微镜视频（平均差异：-264 毫秒，95%CI：-310 至-218 毫秒）均具有统计学意义。参与者报告 2D 和 3D 内窥镜视频的认知负荷最低。在不适、可用性、自然度、深度感知和图像质量方面的评价均倾向于 3D 内窥镜视频。
结论
在知识获取、视野探索和主观评估方面，3D 内窥镜技术在视频学习方面具有许多优势。为了优化学员的学习效果，作者建议在中耳手术中使用内窥镜，如果可能的话，使用 3D 技术。
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