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沉浸式虚拟现实环境对肝脏手术复杂认知技能课程培训的有效性:一项多中心交叉随机试验。

Effectiveness of an immersive virtual reality environment on curricular training for complex cognitive skills in liver surgery: a multicentric crossover randomized trial.

作者信息

Rashidian Nikdokht, Giglio Mariano C, Van Herzeele Isabelle, Smeets Peter, Morise Zenichi, Alseidi Adnan, Troisi Roberto I, Willaert Wouter

机构信息

Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium.

Division of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.

出版信息

HPB (Oxford). 2022 Dec;24(12):2086-2095. doi: 10.1016/j.hpb.2022.07.009. Epub 2022 Jul 21.

Abstract

BACKGROUND

Virtual reality (VR) is increasingly used in surgical education, but evidence of its benefits in complex cognitive training compared to conventional 3-dimensional (3D) visualization methods is lacking. The objective of this study is to assess the impact of 3D liver models rendered visible by VR or desktop interfaces (DIs) on residents' performance in clinical decision-making.

METHOD

From September 2020 to April 2021, a single-blinded, crossover randomized educational intervention trial was conducted at two university hospitals in Belgium and Italy. A proficiency-based stepwise curriculum for preoperative liver surgery planning was developed for general surgery residents. After completing the training, residents were randomized in one of two assessment sequences to evaluate ten real clinical scenarios.

RESULTS

Among the 50 participants, 46 (23 juniors/23 seniors) completed the training and were randomized. Forty residents (86.96%) achieved proficiency in decision-making. The accuracy of virtual surgical planning using VR was higher than that using DI in both groups A (8.43 ± 1.03 vs 6.86 ± 1.79, p < 0.001) and B (8.08 ± 0.9 vs 6.52 ± 1.37, p < 0.001).

CONCLUSION

Proficiency-based curricular training for liver surgery planning successfully resulted in the acquisition of complex cognitive skills. VR was superior to DI visualization of 3D models in decision-making.

GOV ID

NCT04959630.

摘要

背景

虚拟现实(VR)在外科手术教育中的应用越来越广泛,但与传统的三维(3D)可视化方法相比,其在复杂认知训练中的益处尚缺乏证据。本研究的目的是评估通过VR或桌面界面(DI)呈现的3D肝脏模型对住院医师临床决策表现的影响。

方法

2020年9月至2021年4月,在比利时和意大利的两家大学医院进行了一项单盲、交叉随机教育干预试验。为普通外科住院医师制定了基于熟练度的术前肝脏手术规划逐步课程。培训结束后,住院医师被随机分配到两个评估序列之一,以评估十个真实临床场景。

结果

50名参与者中,46名(23名低年级/23名高年级)完成了培训并被随机分组。40名住院医师(86.96%)在决策方面达到了熟练程度。在A组(8.43±1.03 vs 6.86±1.79,p<0.001)和B组(8.08±0.9 vs 6.52±1.37,p<0.001)中,使用VR进行虚拟手术规划的准确性均高于使用DI。

结论

基于熟练度的肝脏手术规划课程培训成功地使学员获得了复杂的认知技能。在决策方面,VR优于3D模型的DI可视化。

政府识别号

NCT04959630。

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