站在外科医生的角度:虚拟现实交叉培训以增强手术中的团队合作。
Stand in surgeon's shoes: virtual reality cross-training to enhance teamwork in surgery.
机构信息
Johns Hopkins University, Baltimore, MD, 21218, USA.
Friedrich-Alexander-Universität, Erlangen, Germany.
出版信息
Int J Comput Assist Radiol Surg. 2024 Jun;19(6):1213-1222. doi: 10.1007/s11548-024-03138-7. Epub 2024 Apr 20.
PURPOSE
Teamwork in surgery depends on a shared mental model of success, i.e., a common understanding of objectives in the operating room. A shared model leads to increased engagement among team members and is associated with fewer complications and overall better outcomes for patients. However, clinical training typically focuses on role-specific skills, leaving individuals to acquire a shared model indirectly through on-the-job experience.
METHODS
We investigate whether virtual reality (VR) cross-training, i.elet@tokeneonedotexposure to other roles, can enhance a shared mental model for non-surgeons more directly. Our study focuses on X-ray guided pelvic trauma surgery, a procedure where successful communication depends on the shared model between the surgeon and a C-arm technologist. We present a VR environment supporting both roles and evaluate a cross-training curriculum in which non-surgeons swap roles with the surgeon.
RESULTS
Exposure to the surgical task resulted in higher engagement with the C-arm technologist role in VR, as measured by the mental demand and effort expended by participants ( ). It also has a significant effect on non-surgeon's mental model of the overall task; novice participants' estimation of the mental demand and effort required for the surgeon's task increases after training, while their perception of overall performance decreases ( ), indicating a gap in understanding based solely on observation. This phenomenon was also present for a professional C-arm technologist.
CONCLUSION
Until now, VR applications for clinical training have focused on virtualizing existing curricula. We demonstrate how novel approaches which are not possible outside of a virtual environment, such as role swapping, may enhance the shared mental model of surgical teams by contextualizing each individual's role within the overall task in a time- and cost-efficient manner. As workflows grow increasingly sophisticated, we see VR curricula as being able to directly foster a shared model for success, ultimately benefiting patient outcomes through more effective teamwork in surgery.
目的
手术中的团队合作依赖于成功的共享心理模型,即对手术室目标的共同理解。共享模型可以提高团队成员的参与度,并与患者的并发症减少和整体预后改善相关。然而,临床培训通常侧重于特定角色的技能,让个人通过在职经验间接获得共享模型。
方法
我们研究了虚拟现实(VR)交叉培训,即接触其他角色,是否可以更直接地增强非外科医生的共享心理模型。我们的研究集中在 X 射线引导骨盆创伤手术上,成功的沟通取决于外科医生和 C 臂技师之间的共享模型。我们提出了一个支持两个角色的 VR 环境,并评估了一个交叉培训课程,其中非外科医生与外科医生交换角色。
结果
暴露于手术任务导致 VR 中对 C 臂技师角色的更高参与度,这可以通过参与者的心理需求和努力程度来衡量( )。它对非外科医生对整体任务的心理模型也有显著影响;新手参与者在培训后对外科医生任务所需的心理需求和努力的估计增加,而他们对整体表现的感知下降( ),表明仅通过观察就存在理解差距。这种现象也存在于专业的 C 臂技师中。
结论
到目前为止,用于临床培训的 VR 应用程序一直专注于虚拟化现有课程。我们展示了在虚拟环境之外不可能实现的新方法,例如角色交换,如何通过以高效和节省成本的方式将每个人的角色置于整体任务的背景下,来增强手术团队的共享心理模型。随着工作流程变得越来越复杂,我们认为 VR 课程能够直接培养成功的共享模型,最终通过手术中更有效的团队合作,使患者受益。