title: Does training in a virtual reality simulator improve surgical performance?
abstract: BACKGROUND
  The development of computerized surgical simulators in a virtual reality environment demands models for proper validation. Recent investigations have shown that a virtual reality simulator (MIST-VR) is a reliable tool for the assessment of laparoscopic psychomotor skills and that it improves the automation of the so-called fulcrum effect. Therefore, we set out to determine whether training with the MIST-VR would improve the surgical performance of surgically inexperienced medical students and to see if results obtained in the simulator would correlate with surgical performance.
  
  
  METHODS
  A total of 29 medical students were randomized into two groups. One group received preoperative MIST-VR training. Both groups then performed a simulated laparoscopic appendectomy in a pig. The operations were videotaped and examined by three independent observers.
  
  
  RESULTS
  There was no significant difference in performance between the two groups. The performance with the MIST-VR correlated with the results in surgery.
  
  
  CONCLUSIONS
  A method that can measure surgical skill, based on the scoring of independent observers who view videotaped performances, seems to be reliable. MIST-VR did not improve the surgical skills of the subjects, but the results with MIST-VR did predict surgical outcome.
authors.affiliation: Department of Surgery, Karolinska Hospital, SE-171 76 Stockholm, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Ahlberg
authors.forename: T
authors.initials: T
authors.lastname: Heikkinen
authors.forename: L
authors.initials: L
authors.lastname: Iselius
authors.forename: C-E
authors.initials: CE
authors.lastname: Leijonmarck
authors.forename: J
authors.initials: J
authors.lastname: Rutqvist
authors.forename: D
authors.initials: D
authors.lastname: Arvidsson
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods; D018961:Educational Technology / Q000379:methods; D013502:General Surgery / Q000193:education*; D006801:Humans; D013337:Students, Medical