Surgical training is undermined by inadequate provision of laparoscopic surgical simulators

Brennan, PM; Loan, James J M; Hughes, MA; Hennessey, Iam; Partridge, RW

doi:10.1308/147363514x14042954769311

Cited by 8 publications

(14 citation statements)

References 14 publications

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“…This study illustrates that the previously reported lack of access to simulators in the United Kingdom 11,12 is a global problem. There is significant enthusiasm for the use of simulators in surgical practice, for both trainee and trained surgeons.…”

Section: Discussionsupporting

confidence: 60%

“…10 Two recent reports have highlighted that surgeons' access to simulation equipment is currently very limited. 11,12 Moreover, with increasing pressure on training time as a result of working time restrictions 13 and cost as an ever present barrier to the availability of simulation hardware, 7 there is growing enthusiasm for the concept of affordable take-home simulation equipment. [14][15][16][17] In addition to skills acquisition, MIS simulators also have roles in skills assessment, [18][19][20] professional revalidation 21 and development of new techniques, 22 with the ultimate aim of improving patient safety.…”

Section: Introductionmentioning

confidence: 99%

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There is a worldwide shortfall of simulation platforms for minimally invasive surgery

Partridge¹,

Hughes²,

Brennan³

et al. 2014

JSS

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Background: The need for simulation in minimally invasive surgery (MIS) has been established. Uptake of simulator training remains poor however. This study quantifies the global availability of simulation equipment, how it is currently used and clinicians' aspirations for the future, including the emerging phenomenon of pre-operative rehearsal/warm-up. Methods: An online survey was distributed to 1314 operating clinicians via a global professional media network. Results: Two hundred ninety-two responses were received from 145 different cities in 63 countries. Responders were drawn from a range of surgical specialties. Only 34% reported access to a simulator during working hours, falling to 20% outside working hours. Forty-six percent had not used a simulator at all in the last 12 months, and only 19% had used it for more than 6 h in the preceding year. Seventy-nine percent supported the idea that a trainee should demonstrate basic competency on a simulator before operating on patients. Three-quarters think that there is a role for take-home MIS simulators; 86% support the use of MIS simulators for pre-operative warm-up, but only 26% currently do this. Conclusion: Worldwide there is great enthusiasm for the integration of simulators into training and surgical practice. Suitable simulation equipment is lacking however. There is strong support for the concept of take-home simulation to address this problem.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

There is a worldwide shortfall of simulation platforms for minimally invasive surgery

Partridge¹,

Hughes²,

Brennan³

et al. 2014

JSS

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“…There is no consistent approach to skill selection, timing of training, feedback or assessments . Other barriers to simulation uptake include perceived inaccessibility of equipment and a lack of time . There is a need to explore novel programs for simulation to increase trainee access to additional surgical training and improve their surgical skills .…”

Section: Introductionmentioning

confidence: 99%

Improved laparoscopic skills in gynaecology trainees following a simulation‐training program using take‐home box trainers

Wilson

Janssens

McLindon

et al. 2018

Aust NZ J Obst Gynaeco

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“…In a recent study, the performance on this simulator has not been shown to be correlated with the FLS scores (Hennessey & Hewett, 2014). Some comparative studies and reviews have shown also the benefit of the FLS trainer compared to LapSim for training basic laparoscopic skills (Fairhurst, Strickland, & Maddern, 2011; Tan, et al, 2012; Hennessey & Hewett, 2014), while another study has concluded that both systems are efficient for training laparoscopic skills with an advantage to the FLS box trainer in regard to its cost effectiveness (Orzech, Palter, Reznick, Aggarwal, & Grantcharov, 2012). Indeed, the annual cost of VR training for 5 residents was estimated to $80,000 USD while it was estimated to $12,000 for the FLS box training (Orzech, Palter, Reznick, Aggarwal, & Grantcharov, 2012).…”

Section: Related Workmentioning

confidence: 99%

“…This increase in cost would inevitably lower the availability of these training systems to most hospitals and learning centers (McMains & Weitzel, 2008). In addition, a recent study has shown that even when these systems are available at the teaching hospitals, they are underused because they are physically locked away, perhaps owing to their cost (Brennan, Loan, Hughes, Hennessey, & Partridge, 2014). The second issue is related to the lack of validity of measurements used to assess the surgical performance on these systems (Stefanidis & Heniford, 2009; Thijssen & Schijven, 2010; Våpenstad & Buzink, 2013; Stunt, Wulms, Kerkhoffs, Dankelman, van Dijk, & Tuijthof, 2014).…”

Section: Related Workmentioning

confidence: 99%

Achieving interface and environment fidelity in the Virtual Basic Laparoscopic Surgical Trainer

Chellali

Mentis

Miller

et al. 2016

International Journal of Human-Computer Studies

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Virtual reality trainers are educational tools with great potential for laparoscopic surgery. They can provide basic skills training in a controlled environment and free of risks for patients. They can also offer objective performance assessment without the need for proctors. However, designing effective user interfaces that allow the acquisition of the appropriate technical skills on these systems remains a challenge. This paper aims to examine a process for achieving interface and environment fidelity during the development of the Virtual Basic Laparoscopic Surgical Trainer (VBLaST). Two iterations of the design process were conducted and evaluated. For that purpose, a total of 42 subjects participated in two experimental studies in which two versions of the VBLaST were compared to the accepted standard in the surgical community for training and assessing basic laparoscopic skills in North America, the FLS box-trainer. Participants performed 10 trials of the peg transfer task on each trainer. The assessment of task performance was based on the validated FLS scoring method. Moreover, a subjective evaluation questionnaire was used to assess the fidelity aspects of the VBLaST relative to the FLS trainer. Finally, a focus group session with expert surgeons was conducted as a comparative situated evaluation after the first design iteration. This session aimed to assess the fidelity aspects of the early VBLaST prototype as compared to the FLS trainer. The results indicate that user performance on the earlier version of the VBLaST resulting from the first design iteration was significantly lower than the performance on the standard FLS box-trainer. The comparative situated evaluation with domain experts permitted us to identify some issues related to the visual, haptic and interface fidelity on this early prototype. Results of the second experiment indicate that the performance on the second generation VBLaST was significantly improved as compared to the first generation and not significantly different from that of the standard FLS box-trainer. Furthermore, the subjects rated the fidelity features of the modified VBLaST version higher than the early version. These findings demonstrate the value of the comparative situated evaluation sessions entailing hands on reflection by domain experts to achieve the environment and interface fidelity and training objectives when designing a virtual reality laparoscopic trainer. This suggests that this method could be used successfully in the future to enhance the value of VR systems as an alternative to physical trainers for laparoscopic surgery skills. Some recommendations on how to use this method to achieve the environment and interface fidelity of a VR laparoscopic surgical trainer are identified.

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Surgical training is undermined by inadequate provision of laparoscopic surgical simulators

Cited by 8 publications

References 14 publications

There is a worldwide shortfall of simulation platforms for minimally invasive surgery

There is a worldwide shortfall of simulation platforms for minimally invasive surgery

Improved laparoscopic skills in gynaecology trainees following a simulation‐training program using take‐home box trainers

Achieving interface and environment fidelity in the Virtual Basic Laparoscopic Surgical Trainer

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