Randomized trial to examine procedure-to-procedure transfer in laparoscopic simulator training

Bjerrum, Flemming; Sørensen, Jette Led; Konge, Lars; Rosthøj, Susanne; Lindschou, Jane; Ottesen, Bent; Strandbygaard, Jeanett

doi:10.1002/bjs.9966

Cited by 34 publications

(20 citation statements)

References 28 publications

(43 reference statements)

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“…1 Thus, surgical trainees must acquire the skills and level of proficiency in laparoscopic surgery. 2 Setbacks and health policies safeguarding patient safety threaten and limit the exposure of surgical trainees to laparoscopic surgery. [3][4][5][6][7] To tackle this problem, surgical training centres provide opportunities through simulation and virtual reality.…”

Section: Introductionmentioning

confidence: 99%

Virtual reality training compared with apprenticeship training in laparoscopic surgery: a meta-analysis

Portelli

Bianco

Bezzina

et al. 2020

annals

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Introduction Since its inception, laparoscopic surgery has evolved and new techniques have been developed due to technological advances. This requires a different and more complex skill set in comparison with open surgery. Reduced working hours, less training time and patient safety factors demand that such skills need to be achieved outside the operating theatre environment. Several studies have been published and have determined the effectiveness of virtual reality training. We aimed to compare virtual reality training with the traditional apprenticeship method of training and determine whether it can supplement or replace the traditional apprenticeship model. We also aimed to perform a meta-analysis of the literature and develop conclusions with respect to the benefits achieved by adding virtual reality training on a regular basis to surgical training programmes. Methods A literature search was carried out on PubMed, MEDLINE, EMBASE and Google Scholar academic search engines using the MESH terms ‘randomised controlled trials’, ‘virtual reality’, ‘laparoscopy’, ‘surgical education’ and ‘surgical training’. All randomised controlled trials published to January 2018 comparing virtual reality training to apprenticeship training were included. Data were collected on improved dexterity, operative performance and operating times. Each outcome was calculated with 95% confidence intervals and with intention-to-treat analysis; 24 randomised controlled trials were analysed. Findings Meta-analytical data were extracted for time, path length, instrument handling, tissue handling, error scores and objective structure assessment of technical skills scoring. There was significant improvement in individual trainee skill in all meta-analyses (p < 0.0002). Conclusion This meta-analysis shows that virtual reality not only improves efficiency in the trainee’s surgical practice but also improves quality with reduced error rates and improved tissue handling.

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Section: Introductionmentioning

confidence: 99%

Virtual reality training compared with apprenticeship training in laparoscopic surgery: a meta-analysis

Portelli

Bianco

Bezzina

et al. 2020

annals

View full text Add to dashboard Cite

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“…Likewise, in another area of orthopaedics, Dubrowski et al 12 suggested that practicing the entire task of bone plating yielded more learning than practicing isolated individual skills. In other surgical fields, Bjerrum et al 4 found little transfer of skills from one laparoscopic procedure to another, while Thomsen et al 31 found no evidence of transfer from one intraocular surgical procedure to another.…”

Section: Discussionmentioning

confidence: 99%

Practicing Procedural Skills Is More Effective Than Basic Psychomotor Training in Knee Arthroscopy: A Randomized Study

Jacobsen

Gustafsson

Jørgensen³

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Simulator-assisted arthroscopy education traditionally consists of initial training of basic psychomotor skills before advancing to more complex procedural tasks. Purpose: To explore and compare the effects of basic psychomotor skills training versus procedural skills training on novice surgeons’ subsequent simulated knee arthroscopy performance. Study Design: Controlled laboratory study. Methods: Overall, 22 novice orthopaedic surgeons and 11 experienced arthroscopic surgeons participated in this study, conducted from September 2015 to January 2017. Novices received a standardized introductory lesson on knee arthroscopy before being randomized into a basic skills training group or a procedural skills training group. Each group performed 2 sessions on a computer-assisted knee arthroscopy simulator: The basic skills training group completed 1 session consisting of basic psychomotor skills modules and 1 session of procedural modules (diagnostic knee arthroscopy and meniscal resection), whereas the procedural skills training group completed 2 sessions of procedural modules. Performance of the novices was compared with that of the experienced surgeons to explore evidence of validity for the basic psychomotor training skills modules and the procedural modules. The effect of prior basic psychomotor skills training and procedural skills training was explored by comparing pre- and posttraining performances of the randomized groups using a mixed-effects regression model. Results: Validity evidence was found for the procedural modules, as test results were reliable and experienced surgeons significantly outperformed novices. We found no evidence of validity for the basic psychomotor skills modules, as test scores were unreliable and there was no difference in performance between the experienced surgeons and novices. We found no statistical effect of basic psychomotor skills training as compared with no training ( P = .49). We found a statistically significant effect of prior procedural skills training ( P < .001) and a significantly larger effect of procedural skills training as compared with basic psychomotor skills training ( P = .019). Conclusion: Procedural skills training was significantly more effective than basic psychomotor skills training regarding improved performance in diagnostic knee arthroscopy and meniscal resection on a knee arthroscopy simulator. Furthermore, the basic psychomotor skills modules lacked validity evidence. Clinical Relevance: On the basis of these results, we suggest that future competency-based curricula focus their training on full knee arthroscopy procedures. This could improve future education programs.

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“…Procedure‐to‐procedure transfer has not been previously investigated for entire ophthalmic procedures, and notably, in laparoscopic surgery, results are inconsistent (Bjerrum et al. ). Basic skills training using instruments similar to real life (black‐box training) has shown to prepare trainees for thoracoscopic lobectomy more effectively than advanced high‐fidelity simulation training in nephrectomy (Jensen et al.…”

Section: Discussionmentioning

confidence: 99%

Intraocular surgery – assessment and transfer of skills using a virtual‐reality simulator

Thomsen

2017

Acta Ophthalmologica

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Randomized trial to examine procedure-to-procedure transfer in laparoscopic simulator training

Abstract: NCT02069951 (http://www.clinicaltrials.gov).

Cited by 34 publications

References 28 publications

Virtual reality training compared with apprenticeship training in laparoscopic surgery: a meta-analysis

Virtual reality training compared with apprenticeship training in laparoscopic surgery: a meta-analysis

Practicing Procedural Skills Is More Effective Than Basic Psychomotor Training in Knee Arthroscopy: A Randomized Study

Intraocular surgery – assessment and transfer of skills using a virtual‐reality simulator

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