Rasmussen's model of human behavior in laparoscopy training.
OBJECTIVE
Compared to aviation, where virtual reality (VR) training has been standardized and simulators have proven their benefits, the objectives, needs, and means of VR training in minimally invasive surgery (MIS) still have to be established. The aim of the study presented is to introduce Rasmussen's model of human behavior as a practical framework for the definition of the training objectives, needs, and means in MIS.


METHODS
Rasmussen distinguishes three levels of human behavior: skill-, rule-, and knowledge-based behaviour. The training needs of a laparoscopic novice can be determined by identifying the specific skill-, rule-, and knowledge-based behavior that is required for performing safe laparoscopy. Future objectives of VR laparoscopy trainers should address all three levels of behavior.


RESULTS
Although most commercially available simulators for laparoscopy aim at training skill-based behavior, especially the training of knowledge-based behavior during complications in surgery will improve safety levels. However, the cost and complexity of a training means increases when the training objectives proceed from the training of skill-based behavior to the training of complex knowledge-based behavior.


CONCLUSIONS
In aviation, human behavior models have been used successfully to integrate the training of skill-, rule-, and knowledge-based behavior in a full flight simulator. Understanding surgeon behavior is one of the first steps towards a future full-scale laparoscopy simulator.
Wentink
M
M
Delft University of Technology, Faculty OCP, Section Man-Machine Systems, Mekelweg 2, 2628 CD, Delft, The Netherlands.
Stassen
L P S
LP
Alwayn
I
I
Hosman
R J A W
RJ
Stassen
H G
HG
D000465:Algorithms; D002983:Clinical Competence; D003198:Computer Simulation; D003657:Decision Making; D013502:General Surgery / Q000193:education*; D006040:Goals; D006801:Humans; D019359:Knowledge; D010535:Laparoscopy; D007858:Learning; D008568:Memory; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D008960:Models, Psychological; D011597:Psychomotor Performance / Q000502:physiology; D021641:Recognition, Psychology; D014584:User-Computer Interface