The effects of practice and instruction on speed and accuracy during resident acquisition of simulated laparoscopic skills

Risucci, Don; Cohen, Jonathan; Garbus, Jules E.; Goldstein, Meridith; Cohen, Matthew G

doi:10.1016/s0149-7944(00)00425-6

Cited by 51 publications

(26 citation statements)

References 8 publications

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“…Summary feedback (i.e., given at the completion of a task) is reported to be most useful for learning as compared to concurrent feedback (given as the task is occurring). [52][53][54][55] Moreover, distributed (as opposed to massed) practice significantly improves learning. 56 Finally, as with the equivalence shown between high-fidelity animal models and low-fidelity benchtop models, high-fidelity benchtop models are equivalent to low-fidelity benchtop models in acquisition of technical skills by novices.…”

Section: Synthetic Modelsmentioning

confidence: 99%

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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Section: Synthetic Modelsmentioning

confidence: 99%

Simulation in surgical education

Palter

Grantcharov²

2010

Canadian Medical Association Journal

121

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“…While this simulation plus skills curricula model intuitively 'makes sense', it has not been the subject of study whereby the additional material is separately evaluated from simulation [25]. While it is surmised that additional tuition improves the level of learning, application of this model warrants further study [49]. This type of simulation teaching with feedback is currently offered to junior urology trainees [50].…”

Section: Integrating Simulation Into the Curriculummentioning

confidence: 99%

Urology technical and non‐technical skills development: the emerging role of simulation

Rashid

Gianduzzo

2015

BJU International

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ObjectiveTo review the emerging role of technical and non-technical simulation in urological education and training. MethodA review was conducted to examine the current role of simulation in urology training. A PUBMED search of the terms 'urology training', 'urology simulation' and 'urology education' revealed 11 504 titles. Three hundred and fifty-seven abstracts were identified as English language, peer reviewed papers pertaining to the role of simulation in urology and related topics. Key papers were used to explore themes. Some cross-referenced papers were also included.

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“…However it is fundamental to establish more efficient training exercises to enhance the dexterity of surgeons and to define objective metrics for assessing their experience and performance. While several metrics [1][2][3] and segmentation procedures [4][5][6] have been employed to characterize different phases of surgical movements in laparoscopy, the extremely small movements and sizes involved in neurosurgery (working field is usually 280-370 [mm 2 ] x h5-10[cm], target size 0.2-1. 5[mm] [7]) have prevented until now the development of similar methodologies and systems.…”

Section: Introductionmentioning

confidence: 99%

Development of the Ultra-Miniaturized Inertial Measurement Unit WB3 for Objective Skill Analysis and Assessment in Neurosurgery: Preliminary Results

Zecca

Sessa

Lin

et al. 2009

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2009

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Abstract. In recent years there has been an ever increasing amount of research and development of technologies and methodologies aimed at improving the safety of advanced surgery. In this context, several training methods and metrics have been proposed, in particular for laparoscopy, both to improve the surgeon's abilities and also to assess her/his skills. For neurosurgery, however, the extremely small movements and sizes involved have prevented until now the development of similar methodologies and systems.In this paper we present the development of the ultra-miniaturized Inertial Measurement Unit WB3 (at present the smallest, lightest, and best performing in the world) for practical application in neurosurgery as skill assessment tool. This paper presents the feasibility study for quantitative discrimination of movements of experienced surgeons and beginners in a simple pick and place scenario.

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The effects of practice and instruction on speed and accuracy during resident acquisition of simulated laparoscopic skills

Cited by 51 publications

References 8 publications

Simulation in surgical education

Simulation in surgical education

Urology technical and non‐technical skills development: the emerging role of simulation

Development of the Ultra-Miniaturized Inertial Measurement Unit WB3 for Objective Skill Analysis and Assessment in Neurosurgery: Preliminary Results

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