Mental practice with interactive 3D visual aids enhances surgical performance

Yiasemidou, Marina; Glassman, Daniel; Mushtaq, Faisal; Athanasiou, Christos; Mon-Williams, Mark; Jayne, David; Mišković, Danilo

doi:10.1007/s00464-017-5459-3

Cited by 25 publications

(12 citation statements)

References 48 publications

(62 reference statements)

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“…The benefits of 'warming up' for optimal surgical performance are becoming clearer, [41][42][43] with emerging evidence indicating that the risk of intraoperative errors related in perceptual identification and spatial orientation might be ameliorated by preoperative interaction with virtual and physical visual aids. 44,45 Such interventions are unlikely to work in isolation, however; healthcare delivery is a complex process involving the interactions of dynamical systems and, as such, interventions at the proximal level need to be considered in the context of the system in which they are embedded. 46…”

Section: Discussionmentioning

confidence: 99%

Contributory factors in surgical incidents as delineated by a confidential reporting system

Mushtaq

O’Driscoll

Smith

et al. 2018

annals

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Background Confidential reporting systems play a key role in capturing information about adverse surgical events. However, the value of these systems is limited if the reports that are generated are not subjected to systematic analysis. The aim of this study was to provide the first systematic analysis of data from a novel surgical confidential reporting system to delineate contributory factors in surgical incidents and document lessons that can be learned. Methods One-hundred and forty-five patient safety incidents submitted to the UK Confidential Reporting System for Surgery over a 10-year period were analysed using an adapted version of the empirically-grounded Yorkshire Contributory Factors Framework. Results The most common factors identified as contributing to reported surgical incidents were cognitive limitations (30.09%), communication failures (16.11%) and a lack of adherence to established policies and procedures (8.81%). The analysis also revealed that adverse events were only rarely related to an isolated, single factor (20.71%) - with the majority of cases involving multiple contributory factors (79.29% of all cases had more than one contributory factor). Examination of active failures - those closest in time and space to the adverse event - pointed to frequent coupling with latent, systems-related contributory factors. Conclusions Specific patterns of errors often underlie surgical adverse events and may therefore be amenable to targeted intervention, including particular forms of training. The findings in this paper confirm the view that surgical errors tend to be multi-factorial in nature, which also necessitates a multi-disciplinary and system-wide approach to bringing about improvements.

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Section: Discussionmentioning

confidence: 99%

Contributory factors in surgical incidents as delineated by a confidential reporting system

Mushtaq

O’Driscoll

Smith

et al. 2018

annals

View full text Add to dashboard Cite

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“…Previous studies conducted by the authors’ group had somewhat different results. The combination of mental rehearsal and 3D anatomical models was found to be effective in enhancing surgical performance in a simulated environment 24 , 25 . Previous studies recruited trainees and medical students, whereas for the present study experts were recruited.…”

Section: Discussionmentioning

confidence: 99%

Patient-specific mental rehearsal with three-dimensional models before low anterior resection: randomized clinical trial

et al. 2020

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Background It was hypothesized that preparing for a surgical procedure, taking into account individual patient characteristics, may facilitate the procedure and improve surgical quality. The aim of this study was to compare different case-specific, preoperative mental rehearsal methods before minimally invasive rectal cancer surgery. Methods In this RCT, patients were allocated in a 1 : 1 : 1 : 1 ratio to four groups: systematic mental rehearsal (SMR) using MRI scans; SMR and three-dimensional (3D) virtual models; SMR and synthetic 3D printed models; and routine practice (control group). Surgeons operating on all but the control group underwent mental rehearsal with the visual aids, including axial MRI scans of the pelvis, interactive 3D virtual models reconstructed from axial MRIs, and synthetic models, manufactured by 3D printing. Operations were video-recorded and assessed by two experts blinded to allocation using two validated scores, the Competency Assessment Tool (CAT) and Objective Clinical Human Reliability Analysis (OCHRA). The primary outcome of the study was surgical performance, measured by the CAT. Results Forty-nine patients were randomized and allocated to the four groups. There were 12 participants in each of the control, MRI and SMR, and virtual and SMR groups, whereas the SMR using physical models and simulation group included 13. No difference was observed between groups in median CAT scores (control 30.50, MRI 34.25, virtual 31.75, physical 34.00; P = 0.748, partial η2 <0.001, where pη2 is indicative of effect size) or OCHRA scores (anterior, posterior, right and left lateral planes, transection P>0.200, pη2 =0.052–0.088). Time spent not performing dissection was significantly shorter for the SMR with MRI group than for the control (57.5 versus 42 respectively; P < 0.001, pη2 =0.212). Conclusion Mental rehearsal did not affect CAT and OCHRA scores of consultant surgeons. Reference number: ISRCTN 75603704 (https://www.isrctn.com).

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“…Such patient-specific 3 D models with the use of VR or MR can be shared with trainees to continue their exposure and improvement in clinical understanding. 11 , 12 For example, Parkhomenko et al compared VR headset usage to present computerised tomography (CT) scans relating to a complex endourological procedure of Percutaneous Nephrolithotomy. 13 Amongst other benefits the interactive VR data improved urologists' understanding of the renal anatomy.…”

Section: Technical Skills Trainingmentioning

confidence: 99%

Role of immersive technologies in healthcare education during the COVID-19 epidemic

et al. 2020

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The unparalleled epidemic of the novel coronavirus (COVID-19), during early December 2019 in Wuhan, China, has rapidly evolved into a global pandemic, became a matter of grave concern. The pandemic presented a unique challenge to government agencies worldwide. The paucity of resources and lack of knowledges to manage the pandemic, coupled with the fear of future consequences has established the need for adoption of emerging and future technologies to address the upcoming challenges. With introduction of measures to control the pandemic, trainees will see a dramatic decline in their in-person exposure to all aspects of their education, with no clear endpoint. This presents an extreme challenge for educators and, given the rapidly evolving situation, there have not yet been training authorities recommendations. We propose several innovative solutions to deliver medical education while maintaining the safety of residents and educators.

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Mental practice with interactive 3D visual aids enhances surgical performance

Cited by 25 publications

References 48 publications

Contributory factors in surgical incidents as delineated by a confidential reporting system

Contributory factors in surgical incidents as delineated by a confidential reporting system

Patient-specific mental rehearsal with three-dimensional models before low anterior resection: randomized clinical trial

Role of immersive technologies in healthcare education during the COVID-19 epidemic

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