Vamadevan Anishan, Konge Lars, Stadeager Morten, Bjerrum Flemming
Copenhagen Academy for Medical Education and Simulation, Centre for HR and Education, The Capital Region, Copenhagen, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Surg Endosc. 2023 Jan;37(1):200-208. doi: 10.1007/s00464-022-09422-4. Epub 2022 Aug 2.
Laparoscopy requires specific psychomotor skills and can be challenging to learn. Most proficiency-based laparoscopic training programs have used non-haptic virtual reality simulators; however, haptic simulators can provide the tactile sensations that the surgeon would experience in the operating room. The objective was to investigate the effect of adding haptic simulators to a proficiency-based laparoscopy training program.
A randomized controlled trial was designed where residents (n = 36) were randomized to proficiency-based laparoscopic simulator training using haptic or non-haptic simulators. Subsequently, participants from the haptic group completed a follow-up test, where they had to reach proficiency again using the non-haptic simulator. Participants from the non-haptic group returned to train until reaching proficiency again using the non-haptic simulator.
Mean completion times during the intervention were 120 min (SD 38.7 min) and 183 min (SD 66.3 min) for the haptic group and the non-haptic group, respectively (p = 0.001). The mean times to proficiency during the follow-up test were 107 min (SD 41.0 min) and 58 min (SD 23.7 min) for the haptic and the non-haptic group, respectively (p < 0.001). The haptic group was not faster to reach proficiency in the follow-up test than during the intervention (p = 0.22). In contrast, the non-haptic group reached the required proficiency level significantly faster in the follow-up test (p < 0.001).
Haptic virtual reality simulators reduce the time to reach proficiency compared to non-haptic simulators. However, the acquired skills are not transferable to the conventional non-haptic setting.
腹腔镜检查需要特定的心理运动技能,学习起来可能具有挑战性。大多数基于熟练程度的腹腔镜培训项目都使用了非触觉虚拟现实模拟器;然而,触觉模拟器可以提供外科医生在手术室中会体验到的触觉感受。目的是研究在基于熟练程度的腹腔镜培训项目中添加触觉模拟器的效果。
设计了一项随机对照试验,将住院医师(n = 36)随机分为使用触觉或非触觉模拟器进行基于熟练程度的腹腔镜模拟器培训。随后,触觉组的参与者完成了一项后续测试,在此测试中他们必须再次使用非触觉模拟器达到熟练程度。非触觉组的参与者返回进行培训,直到再次使用非触觉模拟器达到熟练程度。
干预期间,触觉组和非触觉组的平均完成时间分别为120分钟(标准差38.7分钟)和183分钟(标准差66.3分钟)(p = 0.001)。后续测试中,触觉组和非触觉组达到熟练程度的平均时间分别为107分钟(标准差41.0分钟)和58分钟(标准差23.7分钟)(p < 0.001)。触觉组在后续测试中达到熟练程度的速度并不比干预期间快(p = 0.22)。相比之下,非触觉组在后续测试中达到所需熟练水平的速度明显更快(p < 0.001)。
与非触觉模拟器相比,触觉虚拟现实模拟器可减少达到熟练程度所需的时间。然而,所获得的技能无法转移到传统的非触觉环境中。