Feasibility and fidelity of practising surgical fixation on a virtual ulna bone

Abstract

Background: Surgical simulators provide a safe environment to learn and practise psychomotor skills. A goal for these simulators is to achieve high levels of fidelity. The purpose of this study was to develop a reliable surgical simulator fidelity questionnaire and to assess whether a newly developed virtual haptic simulator for fixation of an ulna has comparable levels of fidelity as Sawbones. Methods:Simulator fidelity questionnaires were developed. We performed a stratified randomized study with surgical trainees. They performed fixation of the ulna using a virtual simulator and Sawbones. They completed the fidelity questionnaires after each procedure.Results: Twenty-two trainees participated in the study. The reliability of the fidelity questionnaire for each separate domain (environment, equipment, psychological) was Cronbach α greater than 0.70, except for virtual environment. The Sawbones had significantly higher levels of fidelity than the virtual simulator (p < 0.001) with a large effect size difference (Cohen d < 1.3). Conclusion:The newly developed fidelity questionnaire is a reliable tool that can potentially be used to determine the fidelity of other surgical simulators. Increasing the fidelity of this virtual simulator is required before its use as a training tool for surgical fixation. The virtual simulator brings with it the added benefits of repeated, independent safe use with immediate, objective feedback and the potential to alter the complexity of the skill.Contexte : Les simulateurs chirurgicaux offrent un environnement sécuritaire pour apprendre et pour exercer les habiletés psychomotrices. L'un des objectifs de ces simulateurs est de produire des degrés élevés de fidélité. Le but de cette étude était de mettre au point un questionnaire fiable sur la fidélité des simulateurs chirurgicaux et de vérifier si un nouveau simulateur virtuel, avec interface haptique, pour la fixation du cubitus présentait des taux de fidélité comparables à ceux du simulateur Sawbones.Méthodes : Des questionnaires sur la fidélité des simulateurs ont été préparés. Nous avons procédé à une étude randomisée stratifiée auprès de stagiaires en chirurgie qui ont effectué une fixation du cubitus à l'aide du simulateur virtuel et à l'aide du simulateur Sawbones. Ils ont répondu au questionnaire sur la fidélité après chaque intervention.Résultats : Vingt-deux stagiaires ont participé à l'étude. La fiabilité du questionnaire sur la fidélité pour chaque domaine distinct (environnement, équipement, dimension psychologique) correspondait à un coefficient α Cronbach supérieur à 0,70, sauf pour ce qui est de l'environnement virtuel. Le simulateur Sawbones a présenté des taux de fidélité significativement plus élevés que le simulateur virtuel (p < 0,001), avec une différence importante au plan de la taille de l'effet (indice d de Cohen < 1,3). Conclusion :Le nouveau questionnaire sur la fidélité s'est révélé un outil fiable qui peut servir à déterminer le degré de fidélité d'autres simulateurs chirurgicaux. Il faudra améliorer la ...

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