Das Bibek, Ledesma Frances, Naik Ravi, Law Sarah, Soleimani-Nouri Payam, Khan Omar A, Mylonas George, Pai Madhava, Ashrafian Hutan, Spalding Duncan, Fehervari Matyas
Department of Surgery and Cancer, Faculty of Medicine, Imperial College London.
East Suffolk and North Essex NHS Foundation Trust.
Int J Surg. 2024 Dec 1;110(12):7414-7420. doi: 10.1097/JS9.0000000000002053.
The COVID-19 pandemic led to a significant reduction in operative exposure for surgical trainees, necessitating alternative training methods to mitigate the impact on surgical education. This study sought to evaluate whether minimally invasive surgery (MIS) skills could be taught remotely using widely available technology with objective assessments of proficiency.
This was a pilot observational study with a comparative assessment of face-to-face (F2F) and virtual training of novice learners in MIS skills. Performance and objective cognitive workload parameters [Surgical Task Load Index (SURG-TLX) score, heart rate, and pupil metrics] were evaluated. The assessments were peg transfer [McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS)] and suturing [Suturing Training and Testing (SUTT)] tasks performed using box trainers. Virtual teaching was conducted by expert trainers using a web-based streaming platform.
Technical challenges of delivering a virtual MIS skills course were addressed after a pilot course. Participants ( n =20) in the final course had similar baseline characteristics and were randomly allocated to F2F ( n =8) and virtual ( n =12) teaching groups. Participants in the online group completed the peg transfer task faster than the F2F group (11.25 min vs. 16.88 min; P =0.015). There were no significant differences in all other MISTELS and SUTT performance measures between groups. Cognitive workload parameters (SURG-TLX score, heart rate, and pupil metrics) were also similar between groups.
This study has demonstrated that virtual teaching of MIS skills using a web-based streaming platform is feasible and effective, providing the foundation for low-cost, effective, and scalable MIS skills programs in the future.
新型冠状病毒肺炎疫情导致外科住院医师的手术操作机会大幅减少,因此需要采用替代培训方法来减轻对外科教育的影响。本研究旨在评估是否可以使用广泛可用的技术远程教授微创手术(MIS)技能,并对熟练程度进行客观评估。
这是一项试点观察性研究,对新手学习者进行MIS技能的面对面(F2F)培训和虚拟培训的比较评估。评估了操作表现和客观认知工作量参数[手术任务负荷指数(SURG-TLX)评分、心率和瞳孔指标]。评估任务为使用箱式训练器进行的移钉[麦吉尔腹腔镜技能训练与评估无生命系统(MISTELS)]和缝合[缝合训练与测试(SUTT)]任务。虚拟教学由专家培训师使用基于网络的流媒体平台进行。
在试点课程之后解决了提供虚拟MIS技能课程的技术难题。最终课程的参与者(n = 20)具有相似的基线特征,并被随机分配到面对面(n = 8)和虚拟(n = 12)教学组。在线组的参与者完成移钉任务的速度比面对面组快(11.25分钟对16.88分钟;P = 0.015)。两组之间在所有其他MISTELS和SUTT操作表现指标上没有显著差异。两组之间的认知工作量参数(SURG-TLX评分、心率和瞳孔指标)也相似。
本研究表明,使用基于网络的流媒体平台对MIS技能进行虚拟教学是可行且有效的,为未来低成本、有效且可扩展的MIS技能培训项目奠定了基础。