MSk Lab, Imperial College London, London, UK.
Ann Surg. 2023 Dec 1;278(6):850-857. doi: 10.1097/SLA.0000000000006079. Epub 2023 Aug 28.
To assess whether multiplayer immersive Virtual Reality (iVR) training was superior to single-player training for the acquisition of both technical and nontechnical skills in learning complex surgery.
Superior teamwork in the operating room (OR) is associated with improved technical performance and clinical outcomes. iVR can successfully train OR staff individually; however, iVR team training has yet to be investigated.
Forty participants were randomized to individual or team iVR training. Individually trained participants practiced alongside virtual avatar counterparts, whereas teams trained live in pairs. Both groups underwent 5 iVR training sessions over 6 weeks. Subsequently, they completed a real-life assessment in which they performed anterior approach total hip arthroplasty surgery on a high-fidelity model with real equipment in a simulated OR. Teams performed together, and individually trained participants were randomly paired up. Videos were marked by 2 blinded assessors recording the 'Non-Operative Technical Skills for Surgeons, Oxford NOn-TECHnical Skills II and Scrub Practitioners' List of Intraoperative Non-Technical Skills' scores. Secondary outcomes were procedure duration and the number of technical errors.
Teams outperformed individually trained participants for nontechnical skills in the real-world assessment (Non-Operative Technical Skills for Surgeons: 13.1±1.5 vs 10.6±1.6, P = 0.002, Non-TECHnical Skills II score: 51.7 ± 5.5 vs 42.3 ± 5.6, P = 0.001 and Scrub Practitioners' List of Intraoperative Non-Technical Skills: 10 ± 1.2 vs 7.9 ± 1.6, P = 0.004). They completed the assessment 33% faster (28.2 minutes ± 5.5 vs 41.8 ± 8.9, P < 0.001), and made fewer than half the number of technical errors (10.4 ± 6.1 vs 22.6 ± 5.4, P < 0.001).
Multiplayer training leads to faster surgery with fewer technical errors and the development of superior nontechnical skills.
评估多人沉浸式虚拟现实(iVR)培训在学习复杂手术的技术和非技术技能方面是否优于单人培训。
手术室(OR)中更好的团队合作与技术性能和临床结果的提高有关。iVR 可以成功地对 OR 工作人员进行个体培训;然而，iVR 团队培训尚未得到研究。
40 名参与者被随机分配到个人或团队 iVR 培训。单独培训的参与者与虚拟化身同伴一起练习，而团队则成对进行现场培训。两组均在 6 周内进行 5 次 iVR 培训。随后，他们在一个模拟 OR 中使用高保真模型和真实设备进行了实际的前路全髋关节置换术评估。团队一起进行手术，而单独培训的参与者则随机配对。视频由 2 名盲评员记录，记录了“外科医生的非手术技术技能、牛津非技术技能 II 和刷手的术中非技术技能清单”评分。次要结果是手术持续时间和技术错误数量。
团队在现实世界评估中的非技术技能表现优于单独培训的参与者(外科医生的非手术技术技能：13.1±1.5 与 10.6±1.6，P = 0.002，非技术技能 II 评分：51.7 ± 5.5 与 42.3 ± 5.6，P = 0.001，刷手的术中非技术技能清单：10 ± 1.2 与 7.9 ± 1.6，P = 0.004)。他们完成评估的速度快了 33%(28.2 分钟 ± 5.5 与 41.8 ± 8.9，P < 0.001)，技术错误数量减少了一半以下(10.4 ± 6.1 与 22.6 ± 5.4，P < 0.001)。
多人培训可实现更快的手术速度，减少技术错误，并培养更好的非技术技能。
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