The relevance of low-fidelity virtual reality simulators compared with other learning methods in basic endovascular skills training

Abstract

Objective: The use of simulators has shown a profound impact on the development of both training and assessment of endovascular skills. Furthermore, there is evidence that simulator training is of great benefit for novice trainees. However, there are only a few simulators available geared specifically toward novice learners. Whereas research suggests that low-fidelity simulators could fill this gap, there are insufficient data available to determine the role of low-fidelity simulators in the training of endovascular skills.Methods: Medical students in their fifth year (N ¼ 50) with no previous endovascular experience were randomized into three groups: conventional learning through a video podcast (group V; n ¼ 12), low-fidelity simulation training with tabletpaired touch-gesture navigation (group A; n ¼ 12), and low-fidelity simulation training with tablet-paired physical endovascular tool navigation (group S; n ¼ 26). Within their respective groups, all students attended a 1-day class on basic endovascular skills. Questionnaire items for self-assessment before and after the class and assessment after the class of the participant's practical skills on a high-fidelity simulator were analyzed across all three groups as well as for each group separately using nonparametric tests.Results: All 50 participants completed the training. Participants in group S showed a significantly increased interest in working in interventional cardiology (P ¼ .02) and vascular surgery (P ¼ .03) after the class. Evaluation of the questionnaire items after the class showed that participants in group S rated their practical skills significantly higher after the class compared with those in group V and group A (P < .001 for pairwise comparison of all three groups, respectively), creating a significant trend across the three groups. However, analysis of the practical skills assessment for all three groups showed a significant difference between the groups only for choosing a guidewire (P ¼ .045) and a significant trend in performance across the groups for choosing a guidewire and for positioning the guidewire in the vessel (P ¼ .02 and P ¼ .05, respectively). All other steps of the skills assessment showed no significant differences or a trend across the groups.Conclusions: Low-fidelity simulation training, particularly with physical endovascular tool navigation, led to increased motivation in novice trainees. Whereas simulator training was associated with increased confidence of trainees in their skills, assessment of their practical skills showed no actual improvement in this study. Overall, low-fidelity simulation has the potential to benefit novice trainees, but possible risks of simulation training should be further evaluated.

Virtual reality in interventional radiology education: a systematic review

“…Interventional radiology, which is one aspect of surgery, encompasses minimally invasive procedures, translating into lower cost, less morbidity, and shorter hospital stays (12) . The greatest difficulties found during the process of learning interventional radiology procedures involve spatial and cognitive proprioception, as well as motor difficulties in using the new equipment, which can have catastrophic consequences at the beginning of a career (14,22) .…”

“…Institutions such as the European Board of Vascular Surgery and the German Society for Vascular Surgery and Vascular Medicine have already implemented or expressed an interest in including simulation-based training as a compulsory part of medical education (14) . However, it remains unknown which simulators are most effective for teaching, in which populations they should actually be implemented, and for what purposes they are indicated.…”

“…The handling of basic materials, such as guidewires, catheters, drains, thermal ablation equipment, and needles, typically presents a challenge at the beginning of the learning process in interventional radiology (14) . Therefore, seeking to enrich the medical teaching methodology, administrators have combined VR with traditional methods, thus broadly aggregating concepts to increase effectiveness as well as to improve surgical skills (15) .…”

The effect of simulator fidelity on procedure skill training: a literature review

“…LF simulation in endovascular procedures was shown to improve motivation in novice trainees but does not necessarily improve practical skills. 40 In one study of psychological stress, junior residents had significantly increased stress during HF simulation compared to LF simulation, while senior surgeons showed no differences. 41 It was also suggested that HF simulators might result in poorer performance by novice trainees because they are over-stimulated by the HF environment.…”

Learning from Artificial Intelligence and Big Data in Health Care

“…9 Finally, AI has also been developed to enable simulation used for the training in vascular surgery. 10 These examples prove that the development of AI together with BD is a major opportunity for vascular surgeons, as these techniques have the potential to improve patient care, evidence based medicine, education, and training. AI has raised promises but, on the downside, has created hype derived from fantasy.…”