South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
Department of Anaesthesia, Liverpool Hospital, Sydney, Australia.
Anaesthesia. 2023 Jun;78(6):739-746. doi: 10.1111/anae.16015. Epub 2023 Apr 3.
Virtual reality is a form of high-fidelity simulation that may be used to enhance the quality of medical education. We created a bespoke virtual reality trainer software using high resolution motion capture and ultrasound imagery to teach cognitive-motor needling skills necessary for the performance of ultrasound-guided regional anaesthesia. The primary objective of this study was to determine the construct validity between novice and experienced regional anaesthetists. Secondary objectives were: to create learning curves for needling performance; compare the virtual environment immersion with other high-fidelity virtual reality software; and compare cognitive task loads imposed by the virtual trainer compared with real-life medical procedures. We recruited 21 novice and 15 experienced participants, each of whom performed 40 needling attempts on four different virtual nerve targets. Performance scores for each attempt were calculated based on measured metrics (needle angulation, withdrawals, time taken) and compared between the groups. The degree of virtual reality immersion was measured using the Presence Questionnaire, and cognitive burden was measured using the NASA-Task Load Index. Scores by experienced participants were significantly higher than novices (p = 0.002) and for each nerve target (84% vs. 77%, p = 0.002; 86% vs. 79%, p = 0.003; 87% vs. 81%, p = 0.002; 87% vs. 80%, p = 0.003). Log-log transformed learning curves demonstrated individual variability in performance over time. The virtual reality trainer was rated as being comparably immersive to other high-fidelity virtual reality software in the realism, possibility to act and quality of interface subscales (all p > 0.06) but not in the possibility to examine and self-performance subscales (all p < 0.009). The virtual reality trainer created workloads similar to those reported in real-life procedural medicine (p = 0.53). This study achieved initial validation of our new virtual reality trainer and allows progression to a planned definitive trial that will compare the effectiveness of virtual reality training on real-life regional anaesthesia performance.
虚拟现实是一种高保真模拟形式，可用于提高医学教育质量。我们使用高分辨率运动捕捉和超声成像创建了定制的虚拟现实培训师软件，以教授执行超声引导区域麻醉所需的认知运动针刺技能。本研究的主要目的是确定新手和经验丰富的区域麻醉师之间的结构有效性。次要目标是：为针刺表现创建学习曲线；将虚拟环境沉浸感与其他高保真虚拟现实软件进行比较；并比较虚拟培训师与现实生活中的医疗程序相比所带来的认知任务负荷。我们招募了 21 名新手和 15 名经验丰富的参与者，他们每个人在四个不同的虚拟神经靶标上进行了 40 次针刺尝试。根据测量指标（针的倾斜角度、撤回、用时）计算每次尝试的表现得分，并在两组之间进行比较。使用存在问卷测量虚拟现实沉浸度，使用 NASA 任务负荷指数测量认知负荷。经验丰富的参与者的得分明显高于新手（p=0.002），并且对于每个神经靶标（84%比 77%，p=0.002；86%比 79%，p=0.003；87%比 81%，p=0.002；87%比 80%，p=0.003）。对数转换的学习曲线显示了个体随时间变化的表现变化。虚拟现实培训师在逼真度、行为可能性和界面质量子量表方面被评为与其他高保真虚拟现实软件具有可比性的沉浸感（所有 p>0.06），但在可检查性和自我表现子量表方面则不然（所有 p<0.009）。虚拟现实培训师产生的工作量与现实生活中程序性医学报告的工作量相似（p=0.53）。本研究初步验证了我们新的虚拟现实培训师的有效性，并允许进行计划的确定性试验，该试验将比较虚拟现实培训对现实生活中区域麻醉效果的影响。
