A prospective randomized study to test the transfer of basic psychomotor skills from virtual reality to physical reality in a comparable training setting.
OBJECTIVE
To test whether basic skills acquired on a virtual endoscopic surgery simulator are transferable from virtual reality to physical reality in a comparable training setting.


BACKGROUND
For surgical training in laparoscopic surgery, new training methods have to be developed that allow surgeons to first practice in a simulated setting before operating on real patients. A virtual endoscopic surgery trainer (VEST) has been developed within the framework of a joint project. Because of principal limitations of simulation techniques, it is essential to know whether training with this simulator is comparable to conventional training.


METHODS
Devices used were the VEST system and a conventional video trainer (CVT). Two basic training tasks were constructed identically (a) as virtual tasks and (b) as mechanical models for the CVT. Test persons were divided into 2 groups each consisting of 12 novices and 4 experts. Each group carried out a defined training program over the course of 4 consecutive days on the VEST or the CVT, respectively. To test the transfer of skills, the groups switched devices on the 5th day. The main parameter was task completion time.


RESULTS
The novices in both groups showed similar learning curves. The mean task completion times decreased significantly over the 4 training days of the study. The task completion times for the control task on Day 5 were significantly lower than on Days 1 and 2. The experts' task completion times were much lower than those of the novices.


CONCLUSIONS
This study showed that training with a computer simulator, just as with the CVT, resulted in a reproducible training effect. The control task showed that skills learned in virtual reality are transferable to the physical reality of a CVT. The fact that the experts showed little improvement demonstrates that the simulation trains surgeons in basic laparoscopic skills learned in years of practice.
Lehmann
Kai S
KS
Department of General Surgery-Chirurgische Klinik I, Charité-Campus Benjamin Franklin, Freie- und Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12200 Berlin, Germany. kai.lehmann@charite.de
Ritz
Joerg P
JP
Maass
Heiko
H
Cakmak
Hueseyin K
HK
Kuehnapfel
Uwe G
UG
Germer
Christoph T
CT
Bretthauer
Georg
G
Buhr
Heinz J
HJ
D002983:Clinical Competence; D003198:Computer Simulation; D004504:Education, Medical, Undergraduate; D013502:General Surgery / Q000193:education; D006801:Humans; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D011597:Psychomotor Performance; D012984:Software; D014584:User-Computer Interface; D014741:Video Recording
Surg Endosc. 2003 Jul;17(7):1082-5
12728373
Ann Surg. 2001 Feb;233(2):159-66
11176120
Endosc Surg Allied Technol. 1993 Jun;1(3):181-4
8055320
Surg Endosc. 2002 Dec;16(12):1732-6
12140638
Br J Surg. 1996 Oct;83(10):1356-60
8944450
Surg Endosc. 2002 Jan;16(1):126-9
11961622
Br J Surg. 2001 Nov;88(11):1525-32
11683753
Surg Endosc. 2002 Apr;16(4):640-5
11972205
Surg Endosc. 2003 Feb;17(2):220-6
12436236
Am J Surg. 1995 Jul;170(1):55-9
7793496
BMJ. 1999 Apr 3;318(7188):887-8
10102830
Surg Endosc. 2001 Oct;15(10):1071-5
11727072
Surg Endosc. 2001 Oct;15(10):1076-9
11727073
Am J Surg. 2003 Feb;185(2):146-9
12559445
Eur J Surg. 2002;168(3):139-44
12182237
Am Surg. 1991 Aug;57(8):542-4; discussion 545
1834000
Surg Endosc. 2002 Dec;16(12):1746-52
12140641
J Laparoendosc Surg. 1993 Jun;3(3):247-9
8347878
Am J Surg. 2001 Jun;181(6):547-50
11513783
Surg Endosc. 2002 Mar;16(3):406-11
11928017
Arch Surg. 1999 Mar;134(3):278-81; discussion 282
10088568
Qual Health Care. 2001 Dec;10 Suppl 2:ii64-9
11700382
Surg Endosc. 2002 Sep;16(9):1324-8
11988802
Surg Endosc. 2003 Feb;17(2):212-5
12457218
Semin Laparosc Surg. 2002 Dec;9(4):198-205
12522776
Ann Surg. 2002 Oct;236(4):458-63; discussion 463-4
12368674