Use of a Low-Cost Portable 3D Virtual Reality Simulator for Psychomotor Skill Training in Minimally Invasive Surgery: Task Metrics and Score Validity

Abstract

Background The high cost and low availability of virtual reality simulators in surgical specialty training programs in low- and middle-income countries make it necessary to develop and obtain sources of validity for new models of low-cost portable simulators that enable ubiquitous learning of psychomotor skills in minimally invasive surgery. Objective The aim of this study was to obtain validity evidence for relationships to other variables, internal structure, and consequences of testing for the task scores of a new low-cost portable simulator mediated by gestures for learning basic psychomotor skills in minimally invasive surgery. This new simulator is called SIMISGEST-VR (Simulator of Minimally Invasive Surgery mediated by Gestures - Virtual Reality). Methods In this prospective observational validity study, the authors looked for multiple sources of evidence (known group construct validity, prior videogaming experience, internal structure, test-retest reliability, and consequences of testing) for the proposed SIMISGEST-VR tasks. Undergraduate students (n=100, reference group), surgical residents (n=20), and experts in minimally invasive surgery (n=28) took part in the study. After answering a demographic questionnaire and watching a video of the tasks to be performed, they individually repeated each task 10 times with each hand. The simulator provided concurrent, immediate, and terminal feedback and obtained the task metrics (time and score). From the reference group, 29 undergraduate students were randomly selected to perform the tasks 6 months later in order to determine test-retest reliability. Results Evidence from multiple sources, including strong intrarater reliability and internal consistency, considerable evidence for the hypothesized consequences of testing, and partial confirmation for relations to other variables, supports the validity of the scores and the metrics used to train and teach basic psychomotor skills for minimally invasive surgery via a new low-cost portable simulator that utilizes interaction technology mediated by gestures. Conclusions The results obtained provided multiple sources of evidence to validate SIMISGEST-VR tasks aimed at training novices with no prior experience and enabling them to learn basic psychomotor skills for minimally invasive surgery.

Virtual Simulation in Undergraduate Medical Education: A Scoping Review of Recent Practice

“…From the 92 published studies, VS was reported to be applied in the educational practice involving undergraduate medical students across 25 countries including the United States [26 studies ( 15 – 40 )], the United Kingdom [9 studies ( 41 – 49 )], Germany [7 studies ( 50 – 56 )], China [6 studies ( 10 , 57 – 61 )], Denmark [6 studies ( 62 – 67 )], France [4 studies ( 68 – 71 )], Japan [4 studies ( 72 – 75 )], Sweden [3 studies ( 76 – 78 )], Canada [3 studies ( 79 – 81 )], Netherlands [3 studies ( 82 – 84 )], Spain [3 studies ( 85 – 87 )], Australia [2 studies ( 88 , 89 )], Singapore [2 studies ( 90 , 91 )], Korea [2 studies ( 92 , 93 )], Finland [1 study ( 94 )], Italy [1 study ( 95 )], Ireland [1 study ( 96 )], Colombia [1 study ( 97 )], Pakistan [1 study ( 98 )], Thailand [1 study ( 99 )], Iran [1 study ( 100 )], Poland [1 study ( 101 )], Mexico [1 study ( 102 )], Norway [1 study ( 103 )], Saudi Arabia [1 study ( 104 )], and Switzerland [1 study ( 105 )]. The distribution of included studies among different continents was shown in Figure 1 .…”

Evaluation of Laparoscopy Virtual Reality Training on the Improvement of Trainees’ Surgical Skills

“…We are aware that the rating for the face evaluation is subjective and influenced by several factors, such as an enthusiastic presentation of the simulator and the motivation of participants to improve performance, consistency of the performance, and the decrease in the number of errors. Nevertheless, the rating for training capacity and realism presented in other studies for different simulator systems are varying in the convincing [ 11 , 12 ], recently several 3D portable simulators, although not being able to demonstrate differences between the performance scores between experts and surgical novices, are still showing good consistency and reliability [ 9 ].…”

“…The second is constructive evaluation, which demonstrates the improvement of the participants in the training session and the ability of the designed task to distinguish the experienced from the inexperienced surgeon based on the performance score. The third step is predictive evaluation, which demonstrates the beneficiary effect of training four weeks afterward on the practice of surgeons addressed with five questions [ 8 , 9 ] ( Appendix A ).…”

An Innovative Approach for Online Neuroanatomy and Neurorrehabilitation Teaching Based on 3D Virtual Anatomical Models Using Leap Motion Controller During COVID-19 Pandemic

“…This increases the teaching realism and meaningful learning thanks to a full interaction with neuroanatomical virtual models. According to this, several authors have analyzed the use of VR and LMC in anatomy teaching and training of surgical and healthcare procedures ( Ferreira dos Santos et al, 2016 ; Yeo et al, 2018 ; Kyaw et al, 2019 ; Alvarez-Lopez et al, 2020 ), or engineering training among others ( Häfner et al, 2013 ). After using LCM, students reported that it was a useful, easy-to-use and effective device for anatomy learning, highlighting its precision for hand and finger recognition ( Nainggolan et al, 2016 ).…”