Psychomotor performance measured in a virtual environment correlates with technical skills in the operating room

Kundhal, Pavi S.; Grantcharov, Teodor P.

doi:10.1007/s00464-008-0043-5

Cited by 96 publications

(59 citation statements)

References 15 publications

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“…To our knowledge, this scoring system has not been used before to evaluate intraocular operations, but has shown an ability to distinguish technical surgical skill in ophthalmic microsurgery (Ezra et al 2009). The OSATS scoring system is also widely used in video-based assessment in other surgical areas (Kundhal & Grantcharov 2009;Schijven et al 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Surgical simulators have long been used for training and assessment in other surgical disciplines and can improve operating skills (Seymour et al 2002;Grantcharov et al 2004;Ahlberg et al 2007;Kundhal & Grantcharov 2009;Schijven et al 2010). The EYESi simulator (VR Magic, Mannheim, Germany) is a commercially available virtual reality (VR) eye surgery simulator for training in both anterior and posterior segment intraocular surgery.…”

Section: Introductionmentioning

confidence: 99%

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Virtual reality cataract surgery training: learning curves and concurrent validity

Selvander

Åsman

2010

Acta Ophthalmologica

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Abstract.Purpose: To investigate initial learning curves on a virtual reality (VR) eye surgery simulator and whether achieved skills are transferable between tasks.Methods: Thirty‐five medical students were randomized to complete ten iterations on either the VR Caspulorhexis module (group A) or the Cataract navigation training module (group B) and then two iterations on the other module. Learning curves were compared between groups. The second Capsulorhexis video was saved and evaluated with the performance rating tool Objective Structured Assessment of Cataract Surgical Skill (OSACSS). The students’ stereoacuity was examined.Results: Both groups demonstrated significant improvements in performance over the 10 iterations: group A for all parameters analysed including score (p < 0.0001), time (p < 0.0001) and corneal damage (p = 0.0003), group B for time (p < 0.0001), corneal damage (p < 0.0001) but not for score (p = 0.752). Training on one module did not improve performance on the other. Capsulorhexis score correlated significantly with evaluation of the videos using the OSACSS performance rating tool. For stereoacuity < and ≥120 seconds of arc, sum of both modules’ second iteration score was 73.5 and 41.0, respectively (p = 0.062).Conclusion: An initial rapid improvement in performance on a simulator with repeated practice was shown. For capsulorhexis, 10 iterations with only simulator feedback are not enough to reach a plateau for overall score. Skills transfer between modules was not found suggesting benefits from training on both modules. Stereoacuity may be of importance in the recruitment and training of new cataract surgeons. Additional studies are needed to investigate this further. Concurrent validity was found for Capsulorhexis module.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Virtual reality cataract surgery training: learning curves and concurrent validity

Selvander

Åsman

2010

Acta Ophthalmologica

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“…Additionally, laparoscopic skills are fundamentally different from those used for traditional open surgery, leading to a prolonged learning curve. Moreover, these skills cannot be acquired exclusively via the old apprenticeship model of observing and assisting (5). Laparoscopic simulators, such as box model trainers and virtual reality simulators (VR) have been used for many years to facilitate the acquisition of skills needed for laparoConventional box model training improves laparoscopic skills during salpingectomy on LapSim: a randomized trial scopic surgery.…”

Section: Introductionmentioning

confidence: 99%

Conventional box model training improves laparoscopic skills during salpingectomy on LapSim: a randomized trial

Akdemir¹,

Ergenoğlu²,

Yeniel³

et al. 2013

J Turkish German Gynecol Assoc

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Objective: Box model trainers have been used for many years to facilitate the improvement of laparoscopic skills. However, there are limited data available on box trainers and their impact on skill acquisition, assessed by virtual reality systems. Material and Methods:Twenty-two Postgraduate Year 1 gynecology residents with no laparoscopic experience were randomly divided into one group that received structured box model training and a control group. All residents performed a salpingectomy on LapSim before and after the training. Performances before and after the training were assessed using LapSim and were recorded using objective parameters, registered by a computer system (time, damage, and economy of motion scores).Results: There were initially no differences between the two groups.The box trainer group showed significantly greater improvement in time (p=0.01) and economy of motion scores (p=0.001) compared with the control group post-training. Conclusion:The present study confirmed the positive effect of low cost box model training on laparoscopic skill acquisition as assessed using LapSim. Novice surgeons should obtain practice on box trainers and teaching centers should make efforts to establish training laboratories. (J Turkish-German Gynecol Assoc 2013; 14: 157-62) Key words: Laparoscopy, skill, box trainer, LapSim Received: 9 July, 2013 Accepted: 25 July, 2013 Amaç: Geleneksel kutu tipi laparoskopi eğitim modelleri yıllardır laparoskopik beceri gelişimini kolaylaştırmak amacıyla kullanılmakta-dırlar. Fakat kutu tipi eğitim modelleri ve bunların laparoskopik beceri kazanılması üzerine etkilerinin sanal gerçeklik sistemler ile değerlen-dirilmesi konusunda sınırlı bilgi mevcuttur. Abstract Özet scopic surgery. The former, which incorporates conventional laparoscopic equipment, is a relatively inexpensive and highly versatile device that enables training on animal parts as well as synthetic inanimate models (6). The latter shows a great potential for both training and assessment purposes. VR replicates laparoscopic instruments as surgeons navigate through and interact with the environment using their natural senses and skills. Now, laparoscopic VR software can replicate procedurespecific tasks such as salpingectomy, tubatomy, myomectomy, and even hysterectomy. It can also be used more easily as an objective tool for assessing laparoscopic skills than the box trainer (5, 7). Gereç veThe aim of the current study was to evaluate the effectiveness of training on the box trainer with regards to salpingectomy training using the LapSim (LapSim ® , Surgical Science, Gothenburg, Sweden) VR simulator. Material and MethodsThe study was conducted as a prospective, randomized, controlled trial. Twenty-two Postgraduate Year 1 gynecology residents with no laparoscopic experience were randomly assigned to either a box trainer group or a control group using the sealed envelope technique. All residents completed a questionnaire regarding demographics, handedness, and any previous experiences with laparoscopic surger...

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“…Kundhal and colleagues previously demonstrated good correlation between LapSim task time and operating room time, as well as good correlation between operating room errors and the tissue damage construct of the LapSim platform in the context of a general surgery MIS program. 8 Schreuder and colleagues demonstrated face validity of LapSim for a gynecology residency program. 9 Woodrum and colleagues used the same tasks as our group to show construct validity of the simulator, 10 although no reference to face validity of these tasks can be demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Construct validity of the LapSim virtual laparoscopic simulator within a urology residency program

Kovac¹,

Azhar²,

Quirouet³

et al. 2012

CUAJ

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Objective: We assessed the construct validity of the LapSim laparoscopic surgical simulator in a urology residency training program. Methods: In total, 15 residents participated in the study between July 2007 and July 2008. The subjects were tested six times at onemonth intervals on three skill tasks (lifting and grasping, cutting and clip application) using the LapSim laparoscopic simulator. The testing sessions were divided into the first three sessions (seminar 1), and the subsequent three sessions (seminar 2). We evaluated the following parameters: total time, path length, angular path length, tissue damage, maximum damage and stretch damage. The subjects were divided into junior (PGY 1,2) and senior resident groups (PGY 3,4,5). The Wilcoxon Signed-Rank test for paired samples was used to compare the performances of the juniors and seniors during seminar 1 to their performance in seminar 2 to determine whether there was improvement over time. The Wilcoxon RankSum test for independent samples was used to compare the performance of the juniors to that of the seniors for seminar 1, seminar 2 and the combination of both seminars to determine whether the more experienced senior residents performed better than the less experienced juniors. Results: No significant performance improvement between testing sessions could be demonstrated. Similarly, there was no significant difference in performance between junior and senior residents. Conclusions: Construct validity could not be demonstrated for the total time, path length, angular path length and tissue handling parameters of the LapSim laparoscopic surgical simulator when examined within the context of a urology residency program.

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Psychomotor performance measured in a virtual environment correlates with technical skills in the operating room

Cited by 96 publications

References 15 publications

Virtual reality cataract surgery training: learning curves and concurrent validity

Virtual reality cataract surgery training: learning curves and concurrent validity

Conventional box model training improves laparoscopic skills during salpingectomy on LapSim: a randomized trial

Construct validity of the LapSim virtual laparoscopic simulator within a urology residency program

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