Validation of a new basic virtual reality simulator for training of basic endoscopic skills

Verdaasdonk, E. G. G.; Stassen, Laurents P. S.; Monteny, L. J.; Dankelman, Jenny

doi:10.1007/s00464-005-0230-6

Cited by 82 publications

(60 citation statements)

References 29 publications

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“…Moreover, they are capable of performing unsupervised assessment of trainees in a whole range of efficiency and quality parameters. Nevertheless, these studies are in many cases scarce, and others report negative [124][125][126] or inconclusive results [77]. This is often the case considering the high variability between studies, concerning participants, definition of surgical levéis, and in general the experiments' contour conditions (previous training in the system, number of repetitions allowed, etc.).…”

Section: Discussionmentioning

confidence: 99%

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Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

131

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Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentortrainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons' psychomotor skills. Ongoing development of tracking systems and software Solutions has allowed for the expansión of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentáis of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as 1 To whom correspondence and reprint requests should be addressed at Bioengineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Universidad Politécnica de Madrid (UPM). Avda Complutense, 30, 28040, Madrid, Spain. E-mail: ioropesa@gbt.tfo. upm.es. well as optimize their already overloaded training schedules.

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Section: Discussionmentioning

confidence: 99%

“…The different VR simulators identified for this review are shown in Table 5 , [64][65][66][67][68][69][70][71][72][73][74][75][76][77]. VR simulators can be differenced by the way they make use of their didactic resources (Fig.…”

Section: Tracking Systems In Virtual Reality Simulatorsmentioning

confidence: 99%

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

131

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“…Previously, the face and content validity of this simulator was established for the single-instrument exercises, and the first results for construct validity were shown [16]. The SIMENDO is a low-fidelity VR simulator developed to train basic endoscopic skills, such as eye-hand coordination, with the use of abstract tasks.…”

Section: Methodsmentioning

confidence: 99%

The influence of different training schedules on the learning of psychomotor skills for endoscopic surgery

et al. 2007

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Background: Psychomotor skills for endoscopic surgery can be trained with virtual reality simulators. Distributed training is more effective than massed training, but it is unclear whether distributed training over several days is more effective than distributed training within 1 day. This study aimed to determine which of these two options is the most effective for training endoscopic psychomotor skills. Methods: Students with no endoscopic experience were randomly assigned either to distributed training on 3 consecutive days (group A, n = 10) or distributed training within 1 day (group B, n = 10). For this study the SIMENDO virtual reality simulator for endoscopic skills was used. The training involved 12 repetitions of three different exercises (drop balls, needle manipulation, 30 o endoscope) in differently distributed training schedules. All the participants performed a posttraining test (posttest) for the trained tasks 7 days after the training. The parameters measured were time, nontarget environment collisions, and instrument path length. Results: There were no significant differences between the groups in the first training session for all the parameters. In the posttest, group A (training over several days) performed 18.7% faster than group B (training on 1 day) (p = 0.013). The collision and path length scores for group A did not differ significantly from the scores for group B. Conclusion: The distributed group trained over several days was faster, with the same number of errors and the same instrument path length used. Psychomotor skill training for endoscopic surgery distributed over several days is superior to training on 1 day.Key words: Endoscopic -Laparoscopic -Psychomotor skills -Training -Training schedules -VR simulatorIn recent years, training of psychomotor skills for endoscopic surgery has been shifted from the operation theater to the skills laboratory. To overcome the difficulties in performing endoscopy such as disturbed hand-eye coordination, visual feedback from a threedimensional (3D) environment to a 2D monitor, and working with long instruments, the surgeon has to practice. Several studies have shown that virtual reality (VR) simulators are useful and valid tools for training psychomotor skills such as hand-eye coordination [5,6,8,9,13,14]. Currently, the training of these skills generally is undertaken in structured courses during 1 or 2 days and continues inside the clinic. With the reduced trainee working hours and the increased pressure on the use of health care facilities, training time needs to be used efficiently. It is therefore important to know how long students should train, when they should train, and what influence different training schedules has on the performance.The effect of different training schedules with respect to their distribution has been studied in other fields such as psychology and neuroscience [1,4,11]. Distributed training refers to a practice schedule in which periods of training are interspersed with rest periods. Massed practice refers to ...

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“…2). Previously, the usefulness and face validity of this simulator with a single instrument was studied [16].…”

Section: Materials and Techniquesmentioning

confidence: 99%

Construct validity and assessment of the learning curve for the SIMENDO endoscopic simulator

et al. 2007

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The SIMENDO is an affordable virtual reality simulator designed to train basic psychomotor skills for endoscopic surgery. This study aimed first to establish construct validity by determining which parameters can discriminate groups with different experience levels, and second to establish the extent to which training is useful by determining when inexperienced groups reach expert level. Methods: The study participants were divided into four groups according to their experience with endoscopic procedures: experienced group (group A, >50 procedures performed, n = 15), intermediate group (group B, 1-50 procedures performed, n = 18), endoscope navigation group (group C, endoscope navigation experience, n = 14), and novice group (group D, no endoscopic experience, n = 14). Each participant performed three repetitions of six consecutive exercises. The parameters studied were task time, path length of the instruments, and number of errors (collisions). Some participants continued training up to 10 repetitions to get insight in the learning curve. Results: Group A (expert) outperformed all the other groups (B, C, and D) in terms of total median task time (p < 0.05), groups C and D in terms of path length, and group D in terms of collision frequency in the first two repetitions. Group B (intermediate) outperformed group D (novice) in total time and endoscope path length for all repetitions, and group C (camera navigation) outperformed group D (novice) in the first repetition. Less experienced groups D and C did not reach expert level for the task time within 10 repetitions, and group B reached it after the eighth repetition (p < 0.05). Conclusion: The study was able to establish construct validity for the training program with the simulator under study. The learning curve showed that training with this simulator is useful for subjects with or without limited endoscopic experience. Furthermore, previous endoscopic camera navigation already improves motor skills to more than the basic level.Key words: Construct validity -LaparoscopyMotor skills -Simulator -Training -Virtual reality Endoscopic virtual reality (VR) trainers have become an attractive and valuable tool for training surgeons in a nonpatient environment. The aim of a simulator is to shorten the learning curve of the trainee for the real job.The SIMENDO (DelltaTech, Delft, The Netherlands) is a recently developed affordable simulator (5-8 thousand euro for software and hardware) aimed at training hand-eye coordination motor skills needed to perform endoscopic surgery. This simulator is designed to provide an easy-to-use plug-and-play system for surgical trainees. It features abstract tasks and simultaneously measures the performance of subjects using various parameters for objective assessment. However, for practical and effective use in the surgical curriculum, tasks and metrics incorporated in the simulator need to be tested for objectivity and reliability. Consequently, each new training device must be assessed and validated.In the literature, the validation ...

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Validation of a new basic virtual reality simulator for training of basic endoscopic skills

Cited by 82 publications

References 29 publications

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

The influence of different training schedules on the learning of psychomotor skills for endoscopic surgery

Construct validity and assessment of the learning curve for the SIMENDO endoscopic simulator

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