A virtual reality simulator for hysteroscopic placement of tubal sterilization micro-inserts: the face and construct validity

Abstract

This study investigated the validity of a virtual reality simulator for hysteroscopic tubal sterilization. Initially performed laparoscopically, the hysteroscopic sterilization method is becoming increasingly popular. An adequate training model could enhance one's skills prior to the start of performing the procedure on the real patient. This prospective study (Canadian Task force II-2) enrolled 69 residents and gynecologists who were divided into three groups, based on vaginoscopic hysteroscopy and Essure® experience level: novices (N=17), intermediates (N=35), and experts (N=17). Participants completed two cases on a virtual reality simulator (EssureSim™) in which four Essure® placements were performed. A questionnaire was completed to assess face validity, and reality scores were given on a 5-point Likert scale. Construct validity was represented by the ability of six simulator-derived parameters to significantly differentiate between different hysteroscopic experience levels. Reality of the sterilization procedure was scored with a median of 5.00 points on a 5-point Likert scale by all participants with prior sterilization experience. Of these participants, 95.5 % indicated the simulator as a useful preparation for real-time Essure® placement. The expert and intermediate group performed both cases significantly faster than novices (p=.001). The novices had a significantly longer path length in comparison to the other groups (p=.006). Analysis of the remaining parameters did not show a persistent ability to differentiate between experience levels. Satisfactory validity was demonstrated for the EssureSim™ by high reality scores and moderate ability to distinguish between different performance levels.

Augmented reality in medical education: students’ experiences and learning outcomes

“…Several simulation-based platforms for teaching colonoscopy to healthcare professional are also available, such as GI Mentor™ and EndoVR™ (CAE Healthcare, the old AccuTouch®, Immersion) [ 39 ]. Hysteroscopy has also been taught for many years using a VR- platform called EssureSim, which has been found to contribute to improved precision amongst the trainees [ 40 ]. More recently, VR training was found to be more effective than the standard guide passive learning tool for teaching a complicated tibial shaft fracture surgical technique [ 41 ].…”

Characteristics of hysteroscopic training models: A review of the literature

“…1 ). Among them, 26 articles introduced hysteroscopic training models [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] ], while 44 articles investigated the training effect of utilizing these models [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ]. Detailed information of these investigations was summarized in Supplementary Tables 2–7 .…”

“…It establishes an authentic interaction between the user and the system while digitally recreating the surgical environment for simulation purposes. According to published articles [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [37] , [38] , [39] , [40] , [41] , [42] ], virtual reality simulators can simulate several hysteroscopic procedures, including diagnostic hysteroscopy, Essure sterilization, polypectomy, myomectomy, septum resection, and rollerball endometrial ablation.…”

“…The following advantages are associated with the utilization of virtual reality simulators in hysteroscopy simulation training: 1. High-fidelity [ 11 , 14 , 16 , 36 , 37 ]: Virtual reality simulators can accurately simulate human anatomical structures and intraoperative problems such as uterine perforation, active bleeding, and difficult uterine distention, aiding trainees in simulating real surgical conditions as closely as possible and in enhancing their adaptability during surgery. 2.…”

From static web to metaverse: reinventing medical education in the post-pandemic era

“…Some examples of the use of AR in surgery can be coupled with better performance of the actual surgical procedure itself and can overlay patient-specific anatomical information obtained from imaging scans, such as in spinal surgeries [ 61 , 62 ], transrectal prostate biopsy [ 63 ], renal surgery [ 63–66 ]. Other platforms are also available for teaching colonoscopies, such as GI Mentor™ and EndoVR™ (CAE Healthcare, the old AccuTouch ® , Immersion) [ 68 ], hysteroscopies such as EssureSim [ 69 ], and complicated tibial shaft fracture surgical techniques [ 70 ]. Further, virtual patients and immersive technologies are integrated into medical curricula, significantly enhancing learning experiences.…”