LapTrain: multi-modality training curriculum for laparoscopic cholecystectomy—results of a randomized controlled trial

Kowalewski, Karl‐Friedrich; Garrow, Carly R.; Proctor, Tanja; Preukschas, Anas; Friedrich, Mirco; Müller, Philip C.; Kenngott, Hannes; Fischer, Lars; Nickel, Felix

doi:10.1007/s00464-018-6110-7

Cited by 48 publications

(47 citation statements)

References 40 publications

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“…The influence of gender on surgical skill acquisition is not clear yet [ 30 ]. Although studies of Schueneman et al [ 31 ] and Madan et al [ 32 ] found some differences between males and females in surgical skill acquisition [ 33 ], the findings of Kolozsvari et al [ 34 ], Grantcharov et al [ 35 ], Nickel et al [ 36 ], and Kowaleski et al [ 37 ] support the results of our study that no correlation between operative performance and gender of participants could be found.…”

Section: Discussionsupporting

confidence: 70%

Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial

Haubruck¹,

Nickel²,

Ober³

et al. 2018

J Med Internet Res

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BackgroundThe insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce.ObjectiveThe aim of this study was to investigate the serious gaming approach in teaching medical students an emergency procedure (chest tube insertion) using the app Touch Surgery and a modified objective structural assessment of technical skills (OSATS).MethodsIn a prospective, rater-blinded, randomized controlled trial, medical students were randomized into two groups: intervention group or control group. Touch Surgery has been established as an innovative and cost-free app for mobile devices. The fully automatic software enables users to train medical procedures and afterwards self-assess their training effort. The module chest tube insertion teaches each key step in the insertion of a chest tube and enables users the meticulous application of a chest tube. In contrast, the module “Thoracocentesis” discusses a basic thoracocentesis. All students attended a lecture regarding chest tube insertion (regular curriculum) and afterwards received a Touch Surgery training lesson: intervention group used the module chest tube insertion and the control group used Thoracocentesis as control training. Participants’ performance in chest tube insertion on a porcine model was rated on-site via blinded face-to-face rating and via video recordings using a modified OSATS tool. Afterwards, every participant received an individual questionnaire for self-evaluation. Here, trainees gave information about their individual training level, as well as previous experiences, gender, and hobbies. Primary end point was operative performance during chest tube insertion by direct observance.ResultsA total of 183 students enrolled, 116 students participated (63.4%), and 21 were excluded because of previous experiences in chest tube insertion. Students were randomized to the intervention group (49/95, 52%) and control group (46/95, 48%). The intervention group performed significantly better than the control group (Intervention group: 38.0 [I50=7.0] points; control group: 30.5 [I50=8.0] points; P<.001). The intervention group showed significantly improved economy of time and motion (P=.004), needed significantly less help (P<.001), and was more confident in handling of instruments (P<.001) than the control group.ConclusionsThe results from this study show that serious games are a valid and effective tool in education of operative performance in chest tube insertion. We believe that serious games should be implemented in the surgical curriculum, as...

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Section: Discussionsupporting

confidence: 70%

Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial

Haubruck¹,

Nickel²,

Ober³

et al. 2018

J Med Internet Res

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“…Therefore, laparoscopic training with CLI and ALI should ideally be combined in a new multi-modality training curriculum to ensure an optimal training benefit with both types of instruments. One approach could be comparable to the multi-modality training for laparoscopic cholecystectomy which has already been explored by Kowaleski and colleagues [22].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of new motorized articulating laparoscopic instruments by laparoscopic novices using a standardized laparoscopic skills curriculum

et al. 2020

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Background Motorized articulating laparoscopic instruments (ALI) offer more degrees of freedom than conventional laparoscopic instruments (CLI). However, a difficult learning curve and complex instrument handling are still a problem of ALI. We compared the performance of new prototypes of motorized ALI with CLI in a series of standardized laparoscopic tasks performed by laparoscopic novices. Further, usability of the new ALI was assessed. Methods A randomized cross-over study with 50 laparoscopic novices who either started with CLI and then changed to ALI (CA) or vice versa (AC) was conducted. All participants performed the European training in basic laparoscopic urological skills (E-BLUS) with each instrument in given order. Time and errors were measured for each exercise. Instrument usability was assessed. Results Overall, using CLI was significantly faster (CLI 4:27 min vs. ALI 4:50 min; p-value 0.005) and associated with fewer exercise failures in needle guidance (CLI 0 vs. ALI 12; p-value 0.0005) than ALI. Median amount of errors was similar for both instruments. Instrument sequence did not matter, as CA and AC showed comparable completion times. Regarding the learning effect, participants were significantly faster in the second attempt of exercises than in the first. In the needle guidance task, participants using CLI last demonstrated a significant speed improvement, whereas ALI were significantly slower in the second run. Regarding usability, CLI were preferred over ALI due to lighter weight and easier handling. Nevertheless, participants valued ALI’s additional degrees of freedom. Conclusion Using new motorized ALI in the E-BLUS examination by laparoscopic novices led to a worse performance compared to CLI. An explanation could be that participants felt overwhelmed by ALI and that ALI have an own distinct learning curve. As participants valued ALI’s additional degrees of freedom, however, a future application of ALI could be for training purposes, ideally in combination with CLI.

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“…Hier verbessert die KI also bereits das Training. Virtual-Reality-Simulatoren haben Ihren Wert in zahlreichen Studien gezeigt und führen zu einem guten Skill Transfer in den realen OP, besonders in Kombination mit anderen Trainingsmodalitäten im multimodalen Trainingskonzept [21,[23][24][25].…”

Section: Augmented-und Virtual-reality-simulatorenunclassified

Machine Learning and Learning Machines: KI in der Aus- und Weiterbildung

et al. 2020

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ZUSAMMENFASSUNGDie Künstliche Intelligenz (KI) geht Hand in Hand mit der Digitalisierung der chirurgischen Aus- und Weiterbildung und wird in der Zukunft immer mehr an Bedeutung gewinnen. Die Anforderungen an KI in der chirurgischen Aus- und Weiterbildung sind vielfältig – genauso vielfältig sind ihre Einsatzmöglichkeiten. KI wird zunehmend im chirurgischen Curriculum berücksichtigt, auch wenn sie manchmal nicht auf den ersten Blick erkennbar ist und durch ihre Algorithmen eher im Hintergrund agiert. Die modernen digitalen Lehrmethoden und Sensortechnik eröffnen neue Wege für die Einbindung der KI in die chirurgische Aus- und Weiterbildung. Die ersten Schritte sind bereits implementiert – KI unterstützt die Erstellung von digitalem Bildmaterial zu Lehrzwecken oder erfasst mithilfe von Sensortechnik die chirurgische Leistung, um diese zu analysieren. Diverse Virtual- und Augmented-Reality-Simulatoren werden nicht nur als effektive Trainingswerkzeuge genutzt, sondern stellen vielmehr wertvolle Quellen für chirurgische Daten dar. All dies birgt enormes Potenzial für neue Erkenntnisse im Bereich der Lehrforschung, was zur Entwicklung von hocheffektiven und evidenzbasierten Lehrkonzepten beiträgt.

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LapTrain: multi-modality training curriculum for laparoscopic cholecystectomy—results of a randomized controlled trial

Abstract: German Clinical Trials Register DRKS00011040.

Cited by 48 publications

References 40 publications

Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial

Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial

Evaluation of new motorized articulating laparoscopic instruments by laparoscopic novices using a standardized laparoscopic skills curriculum

Machine Learning and Learning Machines: KI in der Aus- und Weiterbildung

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