Prospective randomized controlled trial of simulator-based versus traditional in-surgery laparoscopic camera navigation training

Franzeck, Florian M.; Rosenthal, Rachel; Müller, Markus K.; Nocito, Antonio; Wittich, Frauke; Maurus, Christine; Dindo, Daniel; Clavien, Pierre‐Alain; Hahnloser, Dieter

doi:10.1007/s00464-011-1860-5

Cited by 66 publications

(38 citation statements)

References 33 publications

(45 reference statements)

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“…By the subjective GRS, the proficient group performed better on virtual (14 ± 6 [95% confidence interval {CI}, [10][11][12][13][14][15][16][17][18] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…In recent years, there has been increased interest on the use of simulated models for evaluation of surgical proficiency. In a randomized controlled trial in general surgery, Franzeck et al [10] found that simulator-based training may be more efficient than intraoperative training. After experiencing similar on-screen practice times, the laparoscopic simulator group performed similarly to the intraoperatively trained group.…”

Section: Discussionmentioning

confidence: 99%

“…Global rating scales (GRS), procedure times, and motion analysis metrics were used to evaluate performance. Results The proficient group scored higher on virtual (14 ± 6 [95% confidence interval {CI}, [10][11][12][13][14][15][16][17][18] Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request.…”

mentioning

confidence: 99%

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Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Chang

Banaszek

Gambrel

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Work-hour restrictions and fatigue management strategies in surgical training programs continue to evolve in an effort to improve the learning environment and promote safer patient care. In response, training programs must reevaluate how various teaching modalities such as simulation can augment the development of surgical competence in trainees. For surgical simulators to be most useful, it is important to determine whether surgical proficiency can be reliably differentiated using them. To our knowledge, performance on both virtual and benchtop arthroscopy simulators has not been concurrently assessed in the same subjects. Questions/purposes (1) Do global rating scales and procedure time differentiate arthroscopic expertise in virtual and benchtop knee models? (2) Can commercially available built-in motion analysis metrics differentiate arthroscopic expertise? (3) How well are performance measures on virtual and benchtop simulators correlated? (4) Are these metrics sensitive enough to differentiate by year of training? Methods A cross-sectional study of 19 subjects (four medical students, 12 residents, and three staff) were recruited and divided into 11 novice arthroscopists (student to Postgraduate Year [PGY] 3) and eight proficient arthroscopists (PGY 4 to staff) who completed a diagnostic arthroscopy and loose-body retrieval in both virtual and benchtop knee models. Global rating scales (GRS), procedure times, and motion analysis metrics were used to evaluate performance. CI, seconds, p = 0.002). The built-in motion analysis metrics also distinguished novices from proficient arthroscopists using the self-generated virtual loose body retrieval task scores (4 ± 1 [95% CI, 3-5] versus 6 ± 1 [95% CI, 5-7], p = 0.001). GRS scores between virtual and benchtop models were very strongly correlated (q = 0.93, p \ 0.001). There was strong correlation between year of training and virtual GRS (q = 0.8, p \ 0.001) and benchtop GRS (q = 0.87, p \ 0.001) scores. Conclusions To our knowledge, this is the first study to evaluate performance on both virtual and benchtop knee simulators. We have shown that subjective GRS scores and objective motion analysis metrics and procedure time are valid measures to distinguish arthroscopic skill on both virtual and benchtop modalities. Performance on both modalities is well correlated. We believe that training on artificial models allows acquisition of skills in a safe environment. Future work should compare different modalities in the efficiency of skill acquisition, retention, and transferability to the operating room.123 Clin Orthop Relat Res (2016) 474:956-964 DOI 10.1007/s11999-015-4510-8 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® GRS scales. The proficient subjects completed nearly all tasks faster

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“…By the subjective GRS, the proficient group performed better on virtual (14 ± 6 [95% confidence interval {CI}, [10][11][12][13][14][15][16][17][18] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Chang

Banaszek

Gambrel

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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“…Further studies will analyse concurrent validity [8] (comparison between the device and the old technique used for the same training purpose) and predictive validity [8] (whether or not the navigation skills acquired can improve trainee's performance in the operative room) as previously demonstrated by a few studies in relation to more complex and expensive systems [1,3,14,15]. In consideration of the references to clinical practice adopted in the development of the CHT (Table 1), the use of a two-arm prospective study could provide additional validity evidence to this training device.…”

Section: Discussionmentioning

confidence: 99%

“…For visualization of the operative field, surgeons rely daily on camera operators, who are usually the least experienced members of the team. Residents often use a laparoscopic camera for the first time in the operating room (OR) with no previous education or experience [1]. This can lead to sacrificing the additional benefits of an angled laparoscope for the simpler 0° alternative.…”

Section: Introductionmentioning

confidence: 99%

Construct, content and face validity of the camera handling trainer (CHT): a new E-BLUS training task for 30° laparoscope navigation skills

et al. 2015

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competent (p = 0.12) and expert (p = 0.24) participants. All participants agreed that "the CHT is a valid training tool" and that "the CHT should be part of the regular dry laboratory training sessions", assessing both face and content validity. Limitations include the need for assessment of predictive validity. Conclusions The CHT is a valid training tool for 30° laparoscope navigation and thus should be considered as one of the fundamental exercises during basic laparoscopic hands-on training sessions for urologists.Keywords 30° Laparoscopes · Basic laparoscopic skills · Camera handling trainer · E-BLUS · Hands-on training · Laparoscopic camera navigation Abstract Purpose Assessing construct, face and content validity of the camera handling trainer (CHT), a novel low-fidelity training device for 30° laparoscope navigation skills. Methods We developed a custom-designed box trainer with clinically based graphic targets. A total of 117 participants, stratified according to their previous experience (novice, competent, expert), took part to a CHT session and subsequently were asked to fill out a survey to assess the impact of the CHT on their 30° laparoscope navigation skills. Sixty of them were also studied for task performance during a 1-h session, with multiple time measurements. Results All participants, regardless of the previous experience, significantly improved their performance after the CHT session. Regarding construct validity, the mean task performance on the last measurement for novice group was found to be comparable to the mean first attempt of both

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Laparoscopic surgical box model training for surgical trainees with no prior laparoscopic experience

Nagendran

Toon²,

Davidson

et al. 2014

Cochrane Database of Systematic Reviews

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Prospective randomized controlled trial of simulator-based versus traditional in-surgery laparoscopic camera navigation training

Cited by 66 publications

References 33 publications

Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Construct, content and face validity of the camera handling trainer (CHT): a new E-BLUS training task for 30° laparoscope navigation skills

Laparoscopic surgical box model training for surgical trainees with no prior laparoscopic experience

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