Teo Elaine Y L, Choo Samuel Z L, Lin Guann-Hwa, Tan Audrey J L, Chen Yen-Yu, Kirollos Ramez W, Chen Min Wei
Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.
Kyalio, Singapore, Singapore.
Heliyon. 2024 May 25;10(11):e31692. doi: 10.1016/j.heliyon.2024.e31692. eCollection 2024 Jun 15.
Few studies have studied the efficacy of using immersive virtual reality (iVR) to teach surgical skills, especially by using real-world iVR recordings rather than simulations. This study aimed to investigate whether viewing 360° iVR instructional recordings produces greater improvements in basic suturing skills of students without prior medical training, beyond traditional methods like reading written manuals or watching 2D instructional videos.
This was a partially blinded randomized cohort study. 44 pre-university students (aged 17) were randomized equally to either the written instruction manual, 2D instructional video, or iVR recordings. All students first watched a silent 2D demonstration video of the suturing task, before attempting to place three simple interrupted sutures on a piece of meat as a baseline. The time taken for the first attempt was recorded. Students were then given an hour to train using their allocated modality. They attempted the suturing task again, and timings were re-recorded. Four blinded surgically-trained judges independently assessed the quality of the stitches placed both pre and post-intervention. One-way analysis of variance tests (ANOVAs) and independent two-sample t-tests were used to determine the effect of training modality on improvements in suturing scores and time taken to complete suturing from pre to post-training.
For suturing scores, the iVR group showed significantly larger score improvements than the Written Manual group ( = 0.031, Cohen's D = 0.92), while this iVR advantage was less pronounced when compared with the 2D Video group ( = 0.16, Cohen's D = 0.65). Similarly for time taken to complete suturing, the iVR group had significantly larger time improvements than the Written Manual group ( = 0.045), although this difference was less robust compared to the 2D Instructional Video group ( = 0.34).
This study demonstrates that iVR training using real-world 360° instructional recordings produced significantly greater training gains in suturing scores and efficiency compared to reading written text. iVR training also led to larger training gains in both outcome measures than viewing 2D instructional videos, although the differences between them did not reach statistical significance.
很少有研究探讨使用沉浸式虚拟现实（iVR）教授手术技能的效果，尤其是使用现实世界的iVR记录而非模拟。本研究旨在调查观看360° iVR教学记录是否能比阅读书面手册或观看二维教学视频等传统方法，在没有医学培训经历的学生基本缝合技能方面带来更大提升。
这是一项部分盲法随机队列研究。44名大学预科学生（17岁）被平均随机分配到书面指导手册组、二维教学视频组或iVR记录组。所有学生首先观看一段缝合任务的无声二维演示视频，然后尝试在一块肉上放置三根简单间断缝合线作为基线，并记录首次尝试所用时间。之后，学生们有一小时时间使用各自分配的方式进行训练。他们再次尝试缝合任务，并重新记录时间。四名经过外科培训的盲法评委独立评估干预前后所放置缝线的质量。使用单因素方差分析（ANOVA）和独立双样本t检验来确定训练方式对缝合分数提高以及从训练前到训练后完成缝合所用时间的影响。
对于缝合分数，iVR组的分数提升显著大于书面手册组（P = 0.031，科恩d值 = 0.92），而与二维视频组相比，iVR组的这一优势不太明显（P = 0.16，科恩d值 = 0.65）。同样，对于完成缝合所用时间，iVR组的时间改善显著大于书面手册组（P = 0.045），尽管与二维教学视频组相比，这种差异不太显著（P = 0.34）。
本研究表明，与阅读书面文本相比，使用现实世界的360°教学记录进行iVR训练在缝合分数和效率方面产生了显著更大的训练效果。iVR训练在这两个结果指标上也比观看二维教学视频带来更大的训练效果，尽管两者之间的差异未达到统计学显著性。
