Discriminative validity of the Minimally Invasive Surgical Trainer in Virtual Reality (MIST-VR) using criteria levels based on expert performance

Gallagher, Anthony G.; Lederman, Andrew; McGlade, Kieran; Satava, R. M.; Smith, C. Daniel

doi:10.1007/s00464-003-8176-z

Cited by 142 publications

(83 citation statements)

References 17 publications

(35 reference statements)

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“…Rapid ''flooring'' of the error score is also seen in other studies [6]. Apparently, indeed controlled instrument movements avoiding collisions are aptitudes mastered rapidly.…”

Section: Discussionsupporting

confidence: 76%

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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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“…Rapid ''flooring'' of the error score is also seen in other studies [6]. Apparently, indeed controlled instrument movements avoiding collisions are aptitudes mastered rapidly.…”

Section: Discussionsupporting

confidence: 76%

“…Strong discriminative ability between levels of experience for time and path length parameters also is observed with other simulators [4,6,11,[13][14][15]17]. The results in this study suggest that the tasks mimic psychomotor skills needed for endoscopic surgery.…”

Section: Discussionsupporting

confidence: 66%

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

et al. 2007

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“…2 Educators have also expressed concern that new duty hour restrictions limit clinical exposure to critically ill patients and represent an additional challenge to resident competence. 3,4 Simulation-based education improves trainees' knowledge and skills in areas such as invasive procedures, [5][6][7][8][9] communication skills, 10 and management of medical emergencies. [11][12][13] Simulation-based interventions in the ICU setting have also shown promise in promoting resident confidence 14 and critical care skills.…”

Section: Introductionmentioning

confidence: 99%

Retention of Critical Care Skills After Simulation-Based Mastery Learning

Moazed¹,

Cohen²,

Furiasse³

et al. 2013

Journal of Graduate Medical Education

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Background Whether cognitive and patient care skills attained during simulation-based mastery learning (SBML) are retained is largely unknown. Objective We studied retention of intensive care unit (ICU) clinical skills after an SBML boot camp experience. Methods Forty-seven postgraduate year (PGY)-1 residents completed SBML intervention designed to increase procedural, communication, and patient care skills. The intervention included ICU skills such as ventilator and hemodynamic parameter management. Residents were required to meet or exceed a minimum passing score (MPS) on a clinical skills examination before starting actual patient care. Skill retention was assessed in 42 residents who rotated in the medical ICU. Residents received a standardized 15-minute booster teaching session reviewing key concepts during the first week of the rotation. During the fourth week of their rotation, PGY-1 residents completed a clinical skills examination at the bedside of an actual ICU patient. Group mean examination scores and the proportion of subjects who met or exceeded the MPS at each testing occasion were compared. Results Residents scored a mean 90% (SD = 6.5%) on the simulated skills examination immediately after training. Residents retained skills obtained through SBML as the mean score at bedside follow-up testing was 89% (SD = 8.9%, P = .36). Thirty-seven of 42 (88%) PGY-1 residents met or exceeded the MPS at follow-up. Conclusion SBML leads to substantial retention of critical care knowledge, and patient care skills PGY-1 boot camp is a highly efficient and effective model that can be administered at the beginning of the academic year.

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“…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.…”

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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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Discriminative validity of the Minimally Invasive Surgical Trainer in Virtual Reality (MIST-VR) using criteria levels based on expert performance

Cited by 142 publications

References 17 publications

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

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

Retention of Critical Care Skills After Simulation-Based Mastery Learning

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

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