Simulation and Virtual Reality in Surgical Education

Gorman, Paul J.; Meier, Andreas H.; Krummel, Thomas M.

doi:10.1001/archsurg.134.11.1203

Cited by 125 publications

(69 citation statements)

References 61 publications

(49 reference statements)

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“…Virtual reality simulators are types of synthetic simulators where interfacing with the simulator is done through highly realistic (natural) means, and a computer controls nearly all the outputs of simulation events (Gorman et al 1999;Kaufmann & Liu 2001).…”

Section: Level 4: Presentationmentioning

confidence: 99%

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

Chiniara

Cole²,

Brisbin³

et al. 2012

Medical Teacher

181

140

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Background: Simulation in healthcare lacks a dedicated framework and supporting taxonomy for instructional design (ID) to assist educators in creating appropriate simulation learning experiences. Aims: This article aims to fill the identified gap. It provides a conceptual framework for ID of healthcare simulation. Methods: The work is based on published literature and authors' experience with simulation-based education. Results: The framework for ID itself presents four progressive levels describing the educational intervention. Medium is the mode of delivery of instruction. Simulation modality is the broad description of the simulation experience and includes four modalities (computer-based simulation, simulated patient (SP), simulated clinical immersion, and procedural simulation) in addition to mixed, hybrid simulations. Instructional method describes the techniques used for learning. Presentation describes the detailed characteristics of the intervention. The choice of simulation as a learning medium is based on a matrix of simulation relating acuity (severity) to opportunity (frequency) of events, with a corresponding zone of simulation. An accompanying chart assists in the selection of appropriate media and simulation modalities based on learning outcomes. Conclusion: This framework should help educators incorporate simulation in their ID efforts. It also provides a taxonomy to streamline future research and ID efforts in simulation.

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Section: Level 4: Presentationmentioning

confidence: 99%

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

Chiniara

Cole²,

Brisbin³

et al. 2012

Medical Teacher

181

140

View full text Add to dashboard Cite

show abstract

“…Over the past 3 decades, computerassisted devices have been used to augment the education and training of surgical residents in several fields with significant success. [3][4][5][6][7][8] VR simulation already has played an introductory role in training residents for laparoscopic, gastrointestinal, plastic, ophthalmologic, dermatologic, and some laryngologic procedures. 7-14 VR simulation's efficacy as a teaching tool is clear, but whether it is superior to conventional teaching methods has yet to be determined.…”

Section: Role Of a Surgical Simulationmentioning

confidence: 99%

The Use of Surgical Simulators to Reduce Errors

Fried¹,

Satava²,

Weghorst³

et al. 2005

PsycEXTRA Dataset

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The training of a surgeon includes the acquisition of a number of characteristics. These include a cognitive knowledge base, problem formulation and decisionmaking abilities, appropriate psychosocial relationships, and other attributes that can be measured with objective testing, such as national board or specialty certifying examinations. Perhaps most critical to the surgeon, however, are the core technical skills of the profession. A battery of sophisticated devices is being created to teach and provide objective evaluations of the trainee's technical abilities. These innovative state-of-the-art simulation devices, used to teach basic skills and surgical tasks through repetitive proctored challenges, will enable detection and analysis of surgical errors and near miss incidents without risk to patients. As with flight simulation, near miss detection capabilities anticipate potential errors before they occur and prevent resulting complications. In collaboration with a number of otolaryngology residency programs, we have developed a comprehensive training curriculum, based on complementary simulation tools and several perceptual and spatial ability test instruments, to provide objective metrics for assessing the technical skills of trainees. These tools include an endoscopic sinus surgery simulator for procedural training, and the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) system for basic surgical skills training. Technical errors are identified, quantified, and used to monitor surgical performance, after which the metrics are used for outcome analysis, for the purpose of improving patient safety. Validated metrics include time-to-completion, errors, economy of motion, and psychomotor tracking. Endoscopic sinus surgery is a suitable operation substrate, since it is a frequently performed procedure (more than 300,000 times annually in the United States.) and carries a significant risk of injury to the delicate neighboring eye and brain structures. The endoscopic sinus surgery simulator (ES3) is an advanced surgical simulation device based largely on jet pilot flight simulation, and provides the trainee with appropriate levels of challenge and instruction. ES3 validation studies are reported here, along with a description of the World Wide Web-based Intelligent Information Interface (WI3) simulation database.

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“…The choice of the most appropriate training model should take into consideration, among other qualities, efficacy, validity, cost-effectiveness, and versatility [60]. The demand for new, non-clinical, paradigms for surgical skills training has led to the development of a variety of surgical simulation models and methods that refine technique while objectively assessing performance [2,20,42,45,56,58]. Simulation may be defined as a pool of techniques used in conjunction to recreate specific aspects of the real world, thus providing experience in a riskless situation.…”

mentioning

confidence: 99%

“…Examples in neurosurgery include simulators for ventriculostomy [27,30,38], spine needle biopsy [28], pedicle screw placement [26,31], diagnostic cerebral angiography [53], and aneurysm clipping. However, there may be limitations in the ability to transfer these "virtual skills" to physical reality [20,39]. Further development and evaluation is needed in regard to touch, tactile, and force feedback (which vary among simulators) and the complex task of reproducing an appropriate tridimensional environment for visuospatial task training [4,5,20,22].…”

mentioning

confidence: 99%

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The role of simulation in neurosurgery

2014

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It is increasingly apparent that the standards for surgical training are shifting from time-based to criterion-based parameters that emphasize obtaining and maintaining competencies [24]. The formation of a surgeon demands significant dedication and effort, in addition to time [54]. Current, wellestablished methods of surgical training are being challenged as the environment becomes increasingly competitive and litigious with greater scrutiny of patient outcomes [14,17,40,44,50]. In order to increase patient safety and improve treatment outcomes, several strategies such as problem-based learning and objective structured clinical examinations have promoted the development of new curricula in surgical education [13,15,35,51,52].Some of these changes have been driven by events in the 1980s and 1990s such as medical misconduct and overworked, unsupervised resident staff that contributed to patient morbidity and mortality. This also coincided with a growing medical malpractice crisis. As a result, regulatory bodies began to initiate new standards of work hour restrictions and supervision for residents in training. The New York Health Code of 1989 compiled regulations restricting resident work hours (80 h per week) and one day free a week and placed limits on the number of calls [24,32]. Concerns arose about the long-established methods of training surgical residents, and solutions were sought to reduce preventable errors and perioperative complications [24,9].The airline industry, with the development of flight simulators and pilot coaching methods, proved to be an excellent precedent for innovation in surgical education. Many surgical educators believe such methods are keys to accelerating the acquisition of fundamental skills and the rate of performance improvement among surgical residents. A Yale University study demonstrated that criterion-based simulator training decreased operating time by 30 % and operative errors by 85 % [47,48].

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Simulation and Virtual Reality in Surgical Education

Cited by 125 publications

References 61 publications

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

Simulation in healthcare: A taxonomy and a conceptual framework for instructional design and media selection

The Use of Surgical Simulators to Reduce Errors

The role of simulation in neurosurgery

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