Orthopedic Surgery Resident, Graduate Medical Education, Community Memorial Hospital, Ventura, California.
Orthopedic Surgery Resident, Graduate Medical Department, Community Memorial Hospital, Ventura, California.
J Surg Educ. 2022 Nov-Dec;79(6):1526-1535. doi: 10.1016/j.jsurg.2022.06.008. Epub 2022 Jul 19.
The objective of this study was to evaluate the effectiveness of immersive virtual reality training in orthopedic surgery education in comparison to the standard technique guide for fixed-bearing medial unicompartmental knee arthroplasty DESIGN: Participants included 22 orthopedic surgery residents who were randomized to undergo fixed-bearing medial unicompartmental knee arthroplasty (UKA) surgical training with either an immersive virtual reality technology or by studying the traditional technique guide. Participants were randomized within their training year via block randomization. Participants then performed a medial UKA on a SawBone model using standard industry system surgical trays and equipment. Proficiency, timing, number of errors made, and subjective data were obtained during and after the SawBone procedure. A blinded observer was utilized to obtain objective data.
Community Memorial Health System, a primary clinical care institution in Ventura, California.
Twenty-two orthopedic surgery residents were randomly selected. There were 7 PGY-1 residents (3 TG, 4 VR), 7 PGY-2s (4 TG, 3 VR), 3 PGY-3s (1 TG, 2 VR), 3 PGY-4s (2 TG, 1 VR), and 2 PGY-5s (1 TG, 1 VR) in total. Eligibility criteria were 1) an active orthopedic surgery resident, 2) no prior immersive VR surgical training, and 3) no prior experience with the Zimmer PPK implants or its technique guide. All participants completed the study.
Residents were randomized evenly in the virtual reality (n = 11) and technique guide groups (n = 11). Analysis showed that residents who trained with the immersive VR executed significantly more steps correctly (33 vs. 27, p < 0.01) and completed their procedure in significantly faster time (26.7 vs. 35.4 minutes, p < 0.01). They also scored higher in all global assessment categories reaching significance in 4 of 5 categories. Subjective questionnaire responses demonstrated positive feedback within both groups with a trend toward virtual reality. No adverse events were recorded.
Immersive virtual reality was more effective than traditional training for the participants of this study. There are numerous potential applications of this technology and it provides an alternative learning modality to accommodate different learning styles.
本研究旨在评估沉浸式虚拟现实培训在骨科手术教育中的效果，与固定轴承内侧单间膝关节置换术的标准技术指南相比。
参与者包括 22 名骨科住院医师，他们随机接受沉浸式虚拟现实技术或传统技术指南进行固定轴承内侧单间膝关节置换术（UKA）手术培训。参与者在培训年内通过分组随机化进行分组。然后，参与者使用标准行业系统手术托盘和设备在 SawBone 模型上进行内侧 UKA。在 SawBone 手术过程中和之后，获得熟练度、时间、犯错次数和主观数据。使用盲法观察者获取客观数据。
加利福尼亚州文图拉的社区纪念卫生系统，一个初级临床护理机构。
随机选择了 22 名骨科住院医师。有 7 名 PGY-1 住院医师（3 名 TG，4 名 VR），7 名 PGY-2 住院医师（4 名 TG，3 名 VR），3 名 PGY-3 住院医师（1 名 TG，2 名 VR），3 名 PGY-4 住院医师（2 名 TG，1 名 VR）和 2 名 PGY-5 住院医师（1 名 TG，1 名 VR）。入选标准为 1）活跃的骨科住院医师，2）无沉浸式 VR 手术培训史，3）无 Zimmer PPK 植入物或其技术指南经验。所有参与者均完成了研究。
住院医师在虚拟现实（n=11）和技术指南组（n=11）中随机分配均匀。分析表明，使用沉浸式 VR 培训的住院医师正确执行的步骤明显更多（33 比 27，p<0.01），并且完成手术的时间明显更快（26.7 比 35.4 分钟，p<0.01）。他们在所有整体评估类别中的得分都更高，在 5 个类别中有 4 个达到显著水平。主观问卷反应表明两组均有积极反馈，虚拟现实呈趋势。没有记录到不良事件。
与传统培训相比，沉浸式虚拟现实对本研究的参与者更有效。这项技术有许多潜在的应用，它提供了一种替代的学习模式，以适应不同的学习风格。
