Improving Medical Education

Abstract

Virtual simulation is an emerging field in medical education. Research suggests that simulation reduces complication rates and improves learning gains for medical residents. One benefit of simulators is their allowance for more realistic and dynamic patient anatomies. While potentially useful throughout medical education, few studies have explored the impact of dynamic haptic simulators on medical training. In light of this research void, this study was developed to examine how a Dynamic-Haptic Robotic Trainer (DHRT) impacts medical student self-efficacy and skill gains compared to traditional simulators developed to train students in Internal Jugular Central Venous Catheter (IJ CVC) placement. The study was conducted with 18 third year medical students with no prior CVC insertion experience who underwent a pre-test, simulator training (manikin, robotic, or mixed) and post-test. The results revealed the DHRT as a useful method for training CVC skills and supports further research on dynamic haptic trainers in medical education.

Can Haptic Simulators Distinguish Expert Performance? A Case Study in Central Venous Catheterization in Surgical Education

“…The study presented here represents a subset of a larger study that was conducted in summer and fall 2017 to compare the effectiveness of the DHRT system and current manikin simulators 18 . Only the purposes, procedures, methods, and participant information that are relevant to the current investigation are described here.…”

“…This baseline scenario was used in a previous study which showed that the robotic trained novices in the 2016 residency cohort showed significant improvement in performance between the first and last needle insertion – which were both the baseline 27 . The manikin training condition was used in a larger study to compare the effectiveness of the DHRT system and current manikin simulators 18 and thus will not be considered for this study. In addition, the current investigation only considers performance on the first set of 10 needle insertions on the DHRT system to compare novices and expert surgeons.…”

“…After the participant successfully entered the vein or accidently hit the artery, a visual feedback screen generated by the personalized learning system showed their objective performance (e.g. the final needle position, average insertion angle, number of attempts, and distance from center of vein) 15 . This process was repeated until all ten trials were completed.…”

“…A personalized learning system provides automated feedback on performance after each needle placement including the proximity of the needle tip to the center of the vessel, number of insertions, success of insertion attempt, angle of insertion, and any errors that occurred (e.g. arterial puncture), see discussion in Yovanoff et al 15 . Studies have shown that including scenario variations that increase in difficulty when training motor skills increases skill transferability, skill retention and self-efficacy 16,17 .…”

“…Studies have shown that including scenario variations that increase in difficulty when training motor skills increases skill transferability, skill retention and self-efficacy 16,17 . Prior survey-based research on the DHRT system that compared it to traditional static simulators found it to be more effective in training medical students to modify their CVC needle insertion techniques based on patient anatomy 18 . However, in order to compare surgical and clinical improvement gains in the DHRT system, further validation is needed to evaluate suitable metrics for skill gains.…”