Integration and Validation of Hysteroscopy Simulation in the Surgical Training Curriculum

Elessawy, Mohamed; Skrzipczyk, Moritz; Eckmann-Scholz, Christel; Maass, Nicolaì; Mettler, Liselotte; Guenther, Veronika; Mackelenbergh, Marion van; Bauerschlag, Dirk; Alkatout, İbrahim

doi:10.1016/j.jsurg.2016.06.007

Cited by 28 publications

(19 citation statements)

References 9 publications

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“…Although significant improvement in technical ability and decreases in task completion time during five attempts, residents did not reach experts' performance level, indicating that learning curves of the simulated tasks are longer and deserve further studies. However, this finding corroborates the need for hysteroscopic simulation training before a performance in real patients [3,27,28].…”

Section: Discussionsupporting

confidence: 75%

The Development and Psychometric Validation of A Low-Cost Anthropomorphic 3D-Printout Simulator for Training Basic Skills Applicable to Office-Based Hysteroscopy

Panazzolo

Grando

Volpato

et al. 2020

Preprint

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Background Hysteroscopy training requires the development of specific psychomotor skills. Few validated low-cost models exist in hysteroscopy. The main objective of this study is to determine face, content and construct validity of a simulator designed for training basic hysteroscopy skills applied to office-based hysteroscopy.Methods Twenty-five hysteroscopy experts and 30 gynecology residents participated in this prospective observational study. The simulator consisted of three color-textured, silicone-coated anthropomorphic 3-dimensional (3-D) printout uterine models inside a box. Each uterine model in the simulator was designed to developed one of the following basic hysteroscopic skills: hysteroscopic navigation, direct biopsy, and foreign body removal. Participants performed five video-recorded simulation attempts on each model. Procedure-specific checklists were used to rate performance.Results Median scores (25th – 75th percentiles; p-value) 4 (3–4; p < 0.001) and surgical experience associated to the simulated procedures 4 (3–4; p < 0.001) indicated positive perceptions as to the realism of the internal cavity of the simulator. Median scores of 4 (3–4; p < 0.001) were assigned to the realism and utility of the tasks performed in the simulator for enhancing novice training in hysteroscopy. Expert performance scores were significantly higher and task completion times were significantly lower than those of novices in the navigation exercise (F(1,53) = 56.66; p < 0.001), the directed biopsy exercise (F(1,53) = 22.45; p < 0.001), and the foreign body removal exercise (F(1,53) = 58.51; p < 0.001). Novices´ performance improved on all three exercises: navigation exercise (F(1,53) = 182.44; p < 0.001); directed endometrial biopsy (F(1,53) = 110.53; p < 0.001); and foreign body removal (F(1,53) = 58.62; p < 0.001). Experts´ task completion times were significantly lower when compared to that of novices in the five attempts (p < 0,001) of the exercises: navigation (F(1,48) = 25.46; p < 0.001); directed biopsy (F(1,46) = 31.20; p < 0.001); and foreign body removal (F(1,50) = 69.8; p < 0.001). Novices´ task completion times diminished significantly throughout the sequence of exercises.Conclusions The low-cost simulator designed for the acquisition of basic skills in hysteroscopy demonstrated face, content and construct validity.

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Section: Discussionsupporting

confidence: 75%

The Development and Psychometric Validation of A Low-Cost Anthropomorphic 3D-Printout Simulator for Training Basic Skills Applicable to Office-Based Hysteroscopy

Panazzolo

Grando

Volpato

et al. 2020

Preprint

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“…As three-dimensional orientation, reaction skills, and dexterity are required in laparoscopic and robotic-assisted surgery, the effect of video games on laparoscopic skills has been investigated quite extensively. A positive effect was noted in some studies [ 1 , 13 , 14 ]. However, a review of five randomized-controlled trials yielded no relevant difference [ 19 ].…”

Section: Discussionmentioning

confidence: 89%

“…Virtual reality trainers have become an essential part of training in minimally invasive surgery. The impact of virtual reality trainers on surgical performance has been confirmed in several studies [ 1 , 2 , 3 ].…”

Section: Introductionmentioning

confidence: 84%

Impact of Acoustic and Interactive Disruptive Factors during Robot-Assisted Surgery—A Virtual Surgical Training Model

Krüger

Ackermann

Bauerschlag

et al. 2020

Sensors

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The use of virtual reality trainers for teaching minimally invasive surgical techniques has been established for a long time in conventional laparoscopy as well as robotic surgery. The aim of the present study was to evaluate the impact of reproducible disruptive factors on the surgeon’s work. In a cross-sectional investigation, surgeons were tested with regard to the impact of different disruptive factors when doing exercises on a robotic-surgery simulator (Mimic Flex VRTM). Additionally, we collected data about the participants’ professional experience, gender, age, expertise in playing an instrument, and expertise in playing video games. The data were collected during DRUS 2019 (Symposium of the German Society for Robot-assisted Urology). Forty-two surgeons attending DRUS 2019 were asked to participate in a virtual robotic stress training unit. The surgeons worked in various specialties (visceral surgery, gynecology, and urology) and had different levels of expertise. The time taken to complete the exercise (TTCE), the final score (FSC), and blood loss (BL) were measured. In the basic exercise with an interactive disruption, TTCE was significantly longer (p < 0.01) and FSC significantly lower (p < 0.05). No significant difference in TTCE, FSC, or BL was noted in the advanced exercise with acoustic disruption. Performance during disruption was not dependent on the level of surgical experience, gender, age, expertise in playing an instrument, or playing video games. A positive correlation was registered between self-estimation and surgical experience. Interactive disruptions have a greater impact on the performance of a surgeon than acoustic ones. Disruption affects the performance of experienced as well as inexperienced surgeons. Disruption in daily surgery should be evaluated and minimized in the interest of the patient’s safety.

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“…In gynecology, effective simulation models have been described for a variety of advanced procedures including laparoscopic ureteral dissection (19), vaginal hysterectomy (37), trans-vaginal tape placement (38), sacrospinous ligament fixation, and radical hysterectomy (29,39). Use of brief, intensive surgical boot camps has been validated to prepare medical students for an OBGYN residency (40) and to reinforce basic procedural skills for junior residents (39,41) but has yet to be described for advanced reproductive surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Second, surveys were designed to assess the longevity of fellows' comfort with reproductive surgical skills following the boot camp, but conclusions cannot be reached about the impact of the boot camp on persistent changes in knowledge or surgical performance. There is literature to suggest that simulation-based curricula may be beneficial to learn psychomotor skills but continued coaching may be necessary for maintenance of skill (41). Because most surgeries in our cohort were performed during the first year of fellowship, REI fellows may benefit from more evenly distributed clinical time throughout all 3 years.…”

Section: Discussionmentioning

confidence: 99%

Surgical simulation supplements reproductive endocrinology and infertility fellowship training

et al. 2020

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Objective: To assess if a surgical boot camp improves laparoscopic skill among reproduction endocrinology and infertility (REI) fellows and increases fellow desire to incorporate surgical skills into practice and to examine whether fellowship in vitro fertilization (IVF) volume correlates with surgical efficiency. Design: Prospective evaluation. Setting: Simulation Center. Patient(s): Forty REI fellows. Intervention(s): Fellows were timed before and after training in laparoscopic suturing and knot tying and while using virtual simulators. Fellows were surveyed before boot camp on prior experience with IVF and reproductive surgery, and immediately and 1 month after boot camp on their desire to incorporate surgical skills into practice. Main Outcome Measure(s): Efficiency of laparoscopic suturing and knot tying before and after boot camp; likelihood and persistence of incorporating surgical skills into practice immediately and 1 month after boot camp; and correlation between fellowship IVF volume and fellow surgical efficiency. Result(s): Fellows experienced significant improvement in laparoscopic suturing (44 sec), intracorporeal knot tying (82 sec), and extracorporeal knot tying (71 sec). Fellows reported being more likely to incorporate operative hysteroscopy (89%), operative laparoscopy (87%), and laparoscopic suturing (84%) into practice immediately following boot camp with no difference 1 month later. Fifty-four percent of fellows reported being more likely to perform robotic surgery after the boot camp, increasing to 70% 1 month later. There were weak correlations between IVF case volume and efficiency in laparoscopic suturing or hysteroscopic polypectomy (Spearman correlation coefficients,-0.14 and-0.03). Conclusion(s): An intensive surgical boot camp enhances surgical skill among REI fellows.

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Integration and Validation of Hysteroscopy Simulation in the Surgical Training Curriculum

Cited by 28 publications

References 9 publications

The Development and Psychometric Validation of A Low-Cost Anthropomorphic 3D-Printout Simulator for Training Basic Skills Applicable to Office-Based Hysteroscopy

The Development and Psychometric Validation of A Low-Cost Anthropomorphic 3D-Printout Simulator for Training Basic Skills Applicable to Office-Based Hysteroscopy

Impact of Acoustic and Interactive Disruptive Factors during Robot-Assisted Surgery—A Virtual Surgical Training Model

Surgical simulation supplements reproductive endocrinology and infertility fellowship training

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