Limits...
Novices outperform experienced laparoscopists on virtual reality laparoscopy simulator.

Moore AK, Grow DR, Bush RW, Seymour NE - JSLS (2008 Oct-Dec)

Bottom Line: Attending physicians performed poorly when compared with medical students, requiring more than twice the number of attempts to reach proficiency (Mann-Whitney P<0.01).Increased operating room experience and age were associated with worsening simulator performance.Caution should be exercised when considering current virtual reality simulator technology as a measure of experience or ability among gynecologic surgeons.

View Article: PubMed Central - PubMed

Affiliation: Department of OB/GYN, Baystate Medical Center, Springfield, Massachusetts, USA. andrew.mooore@nhs.org

ABSTRACT

Background and objectives: Virtual reality has been poorly studied among gynecologic surgeons. The aim of this study was to evaluate whether performance on the Minimally Invasive Surgery Trainer-Virtual Reality (MIST-VR) laparoscopic trainer reflects laparoscopic experience among gynecologic surgeons and trainees.

Methods: Twenty-six medical students, residents, and attending gynecologic surgeons completed a MIST-VR training program. A new simulated task was then presented to each participant, who repeated the task until proficiency was reached.

Results: Attending physicians performed poorly when compared with medical students, requiring more than twice the number of attempts to reach proficiency (Mann-Whitney P<0.01). Among medical students and residents, there was an association between years of live laparoscopy experience and poor simulator performance (Spearman r P=0.01).

Conclusion: Increased operating room experience and age were associated with worsening simulator performance. Several potential explanations for this trend are discussed, including lack of tactile and contextual feedback. Caution should be exercised when considering current virtual reality simulator technology as a measure of experience or ability among gynecologic surgeons.

Show MeSH
Average number of attempts required to reach proficiency on the MIST-VR manipulative diathermy task by participant group. *Mann-Whitney test: attending vs. medical student P=0.01, attending vs. resident P=0.14, resident vs. med student P=0.15.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3015992&req=5

Figure 4: Average number of attempts required to reach proficiency on the MIST-VR manipulative diathermy task by participant group. *Mann-Whitney test: attending vs. medical student P=0.01, attending vs. resident P=0.14, resident vs. med student P=0.15.

Mentions: The primary outcome measure was the number of task repetitions required for the participants to reach minimal proficiency. Years of experience and age were correlated with the number of task repetitions required to reach minimal proficiency (Figures 2 to 4). Because we made no attempt to quantify the level of experience of the attendings beyond verifying that they regularly performed laparoscopic surgery, attendings were excluded from the experience vs proficiency analysis (Figure 2). Attending surgeons performed an average of 30 laparoscopic procedures per year, ranging from 12 to 61 procedures per year. Attendings were included in a second nonparametric correlation analysis in which age was used as a surrogate for experience (Figure 3). There was no overlap in age between the medical student, resident, and attending groups with the exception of a 30-year-old medical student and a 49-year-old resident. Average number of attempts required to reach proficiency in the medical student, resident, and attending groups were compared using a Mann-Whitney test in a post-hoc analysis (Figure 4). Statistical tests were performed using GraphPad InStat statistical software.


Novices outperform experienced laparoscopists on virtual reality laparoscopy simulator.

Moore AK, Grow DR, Bush RW, Seymour NE - JSLS (2008 Oct-Dec)

Average number of attempts required to reach proficiency on the MIST-VR manipulative diathermy task by participant group. *Mann-Whitney test: attending vs. medical student P=0.01, attending vs. resident P=0.14, resident vs. med student P=0.15.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3015992&req=5

Figure 4: Average number of attempts required to reach proficiency on the MIST-VR manipulative diathermy task by participant group. *Mann-Whitney test: attending vs. medical student P=0.01, attending vs. resident P=0.14, resident vs. med student P=0.15.
Mentions: The primary outcome measure was the number of task repetitions required for the participants to reach minimal proficiency. Years of experience and age were correlated with the number of task repetitions required to reach minimal proficiency (Figures 2 to 4). Because we made no attempt to quantify the level of experience of the attendings beyond verifying that they regularly performed laparoscopic surgery, attendings were excluded from the experience vs proficiency analysis (Figure 2). Attending surgeons performed an average of 30 laparoscopic procedures per year, ranging from 12 to 61 procedures per year. Attendings were included in a second nonparametric correlation analysis in which age was used as a surrogate for experience (Figure 3). There was no overlap in age between the medical student, resident, and attending groups with the exception of a 30-year-old medical student and a 49-year-old resident. Average number of attempts required to reach proficiency in the medical student, resident, and attending groups were compared using a Mann-Whitney test in a post-hoc analysis (Figure 4). Statistical tests were performed using GraphPad InStat statistical software.

Bottom Line: Attending physicians performed poorly when compared with medical students, requiring more than twice the number of attempts to reach proficiency (Mann-Whitney P<0.01).Increased operating room experience and age were associated with worsening simulator performance.Caution should be exercised when considering current virtual reality simulator technology as a measure of experience or ability among gynecologic surgeons.

View Article: PubMed Central - PubMed

Affiliation: Department of OB/GYN, Baystate Medical Center, Springfield, Massachusetts, USA. andrew.mooore@nhs.org

ABSTRACT

Background and objectives: Virtual reality has been poorly studied among gynecologic surgeons. The aim of this study was to evaluate whether performance on the Minimally Invasive Surgery Trainer-Virtual Reality (MIST-VR) laparoscopic trainer reflects laparoscopic experience among gynecologic surgeons and trainees.

Methods: Twenty-six medical students, residents, and attending gynecologic surgeons completed a MIST-VR training program. A new simulated task was then presented to each participant, who repeated the task until proficiency was reached.

Results: Attending physicians performed poorly when compared with medical students, requiring more than twice the number of attempts to reach proficiency (Mann-Whitney P<0.01). Among medical students and residents, there was an association between years of live laparoscopy experience and poor simulator performance (Spearman r P=0.01).

Conclusion: Increased operating room experience and age were associated with worsening simulator performance. Several potential explanations for this trend are discussed, including lack of tactile and contextual feedback. Caution should be exercised when considering current virtual reality simulator technology as a measure of experience or ability among gynecologic surgeons.

Show MeSH