Laboratory-based vascular anastomosis training: A randomized controlled trial evaluating the effects of bench model fidelity and level of training on skill acquisition

Sidhu, Ravi; Park, Jason; Brydges, Ryan; MacRae, Helen; Dubrowski, Adam

doi:10.1016/j.jvs.2006.09.040

Cited by 143 publications

(138 citation statements)

References 14 publications

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“…A strong preference for the low-fidelity model was noted with regard to learning the three methods of conventional TBNA. Investigators in other fields have similarly not observed an educational advantage in the usage of the often more expensive high-fidelity virtual-reality simulation platform [25,27,30,33,34,35], although some have reported superiority in user-satisfaction-related measures such as learner enthusiasm, and ability to integrate basic discreet tasks into more complex operations [24,36]. …”

Section: Discussionmentioning

confidence: 99%

“…While in many procedural fields investigators have explored the comparative educational efficacy, usability and user satisfaction of low- and high-fidelity simulation [23,24,25,26,27,28,29,30], a comparative study of the educational effectiveness of low- and high-fidelity models in the realm of minimally invasive bronchoscopic procedures has not been reported. The purpose of this study, therefore, was to determine the perceptions and preferences of learners and instructors regarding the comparative effectiveness of low- and high-fidelity bronchoscopy simulation for training in conventional TBNA.…”

Section: Background and Purposementioning

confidence: 99%

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Comparative Effectiveness of Low- and High-Fidelity Bronchoscopy Simulation for Training in Conventional Transbronchial Needle Aspiration and User Preferences

et al. 2010

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Background: Conventional transbronchial needle aspiration (TBNA) can be learned using high-fidelity virtual-reality platforms and low-fidelity models comprised of molded silicone or excised animal airways. Objectives: The purpose of this study was to determine perceptions and preferences of learners and instructors regarding the comparative effectiveness of low-fidelity and high-fidelity bronchoscopy simulation for training in TBNA. Methods: During the 2008 annual CHEST conference, a prospective randomized crossover design was used to train study participants in three methods of conventional TBNA using low- and high-fidelity models. Likert style questions were administered to learners and instructors in order to elicit preferences and opinions regarding educational effectiveness of the models. Results were tabulated and depicted in graphic format, with medians calculated. Results: Learners felt that the models were equally enjoyable (13–13) and enthusiasm generating (low 17-high 15). There was preference for low-fidelity in terms of realism (23–17), ease of learning (20–6), and learning all three TBNA methods (31–7 for hub-against-wall, 31–6 for jabbing, 29–6 for piggyback). Low-fidelity was preferred as an ideal model overall (19–11). Instructors thought that low-fidelity was more useful in teaching TBNA (9–0 for all three methods). Instructors perceived the low-fidelity model overall as an ideal tool for learning TBNA (8–0) and a more effective teaching instrument (8–0). Conclusion: Based on learner and instructor perceptions, a low-fidelity model is superior to a high-fidelity platform for training in three methods of conventional TBNA.

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Section: Discussionmentioning

confidence: 99%

Section: Background and Purposementioning

confidence: 99%

Comparative Effectiveness of Low- and High-Fidelity Bronchoscopy Simulation for Training in Conventional Transbronchial Needle Aspiration and User Preferences

et al. 2010

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“…46 These studies illustrate that inexpensive, reliable and valid models exist that are equivalent to animal or cadaveric models for training novice surgeons.…”

Section: Analysis Of Dexteritymentioning

confidence: 90%

Simulation in surgical education

Palter

Grantcharov²

2010

Canadian Medical Association Journal

121

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Key points• Both technical and non-technical skills are essential for surgeons in training.• Technical skills learned on low-fidelity benchtop models, video-based trainers and virtual-reality models are transferable to the operating room.• Current evidence does not show a clear advantage of either virtual reality or synthetic models in teaching technical skills.• Evidence is lacking on how best to integrate each type of simulator into a holistic, proficiency-based curriculum. Simulation in surgical educationVanessa N. Palter MD, Teodor P. Grantcharov MD PhDPreviously published at www.cmaj.caReview those used for teaching minimally invasive procedures (referred to as tower trainers or video-box trainers). Numerous benchtop models are available for the simulation of a variety of procedures, including knot-tying, fascial closure, and suturing 14 (Figure 1). The most obvious limitation of such models is that they teach only one surgical technique rather than an entire operation. 5 Their use requires the presence of an expert to demonstrate the procedure and provide feedback on performance. 1,5 Tower trainers include a box with slits on the superior surface for trocar insertion. Real laparoscopic instruments are inserted through the trocars into the box, where the procedure is simulated. A camera inside the box provides video output to a monitor on which trainees can watch their own movements. These models can simulate a variety of techniques, including laparoscopic suturing, knot-tying, clip-applying and coordination drills.14 One of the most well-described tower trainers is the physical laparoscopy trainer known as the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills. This system consists of five tasks performed on an endotrainer box. 16 The tasks include peg transfer, cutting, placing a ligating loop and intracorporeal suturing. Virtual-reality simulationTraining by virtual-reality simulation encompasses systems designed to teach laparoscopic, endoscopic and percutaneous interventions. 13 The fidelity of virtual-reality simulators ranges widely, from the Minimally Invasive Surgical Trainer -Virtual Reality (MIST-VR) system, which is a low-fidelity system designed to teach general laparoscopic proficiency, to systems that teach component procedural skills and other systems that replicate entire operations 17 ( Figure 2 and Videos 1 and 2, available at www .cmaj .ca /cgi /content /full /cmaj .091743 /DC1). Unlike bench-model learning, the presence of an expert is not necessary when virtual-reality simulation is used. Such models allow for practice at varying levels of difficulty, can simulate complications and automatically provide objective measures of assessment, allowing for both formative and summative trainee assessment.18 Virtual-reality models have been criticized, however, for high initial cost of system acquisition, limited force-feedback with use of surgical instruments and lack of realism of graphics. 14,19The virtual operating room Benchtop models, virtual-reality models, and an...

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“…High-fidelity and low-fidelity simulators can have equally positive impacts on learning for novice students. 24,[72][73][74] Hence, the purchase of high-cost high-fidelity simulators must be considered thoughtfully, especially for use early in the learning curve. Moreover, rather than comparing low-fidelity with high-fidelity simulators, new studies have suggested that a better approach may be to structure the simulation experience as a progressive training program.…”

Section: Fidelitymentioning

confidence: 99%

Review article: Simulation in anesthesia: state of the science and looking forward

LeBlanc

2011

Can J Anesth/J Can Anesth

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Laboratory-based vascular anastomosis training: A randomized controlled trial evaluating the effects of bench model fidelity and level of training on skill acquisition

Cited by 143 publications

References 14 publications

Comparative Effectiveness of Low- and High-Fidelity Bronchoscopy Simulation for Training in Conventional Transbronchial Needle Aspiration and User Preferences

Comparative Effectiveness of Low- and High-Fidelity Bronchoscopy Simulation for Training in Conventional Transbronchial Needle Aspiration and User Preferences

Simulation in surgical education

Review article: Simulation in anesthesia: state of the science and looking forward

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