title: A prospective randomized study to test the transfer of basic psychomotor skills from virtual reality to physical reality in a comparable training setting.
abstract: 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.
authors.affiliation: 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
authors.forename: Kai S
authors.initials: KS
authors.lastname: Lehmann
authors.forename: Joerg P
authors.initials: JP
authors.lastname: Ritz
authors.forename: Heiko
authors.initials: H
authors.lastname: Maass
authors.forename: Hueseyin K
authors.initials: HK
authors.lastname: Cakmak
authors.forename: Uwe G
authors.initials: UG
authors.lastname: Kuehnapfel
authors.forename: Christoph T
authors.initials: CT
authors.lastname: Germer
authors.forename: Georg
authors.initials: G
authors.lastname: Bretthauer
authors.forename: Heinz J
authors.initials: HJ
authors.lastname: Buhr
mesh_terms: 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
references.citation: Surg Endosc. 2003 Jul;17(7):1082-5
references.pmid: 12728373
references.citation: Ann Surg. 2001 Feb;233(2):159-66
references.pmid: 11176120
references.citation: Endosc Surg Allied Technol. 1993 Jun;1(3):181-4
references.pmid: 8055320
references.citation: Surg Endosc. 2002 Dec;16(12):1732-6
references.pmid: 12140638
references.citation: Br J Surg. 1996 Oct;83(10):1356-60
references.pmid: 8944450
references.citation: Surg Endosc. 2002 Jan;16(1):126-9
references.pmid: 11961622
references.citation: Br J Surg. 2001 Nov;88(11):1525-32
references.pmid: 11683753
references.citation: Surg Endosc. 2002 Apr;16(4):640-5
references.pmid: 11972205
references.citation: Surg Endosc. 2003 Feb;17(2):220-6
references.pmid: 12436236
references.citation: Am J Surg. 1995 Jul;170(1):55-9
references.pmid: 7793496
references.citation: BMJ. 1999 Apr 3;318(7188):887-8
references.pmid: 10102830
references.citation: Surg Endosc. 2001 Oct;15(10):1071-5
references.pmid: 11727072
references.citation: Surg Endosc. 2001 Oct;15(10):1076-9
references.pmid: 11727073
references.citation: Am J Surg. 2003 Feb;185(2):146-9
references.pmid: 12559445
references.citation: Eur J Surg. 2002;168(3):139-44
references.pmid: 12182237
references.citation: Am Surg. 1991 Aug;57(8):542-4; discussion 545
references.pmid: 1834000
references.citation: Surg Endosc. 2002 Dec;16(12):1746-52
references.pmid: 12140641
references.citation: J Laparoendosc Surg. 1993 Jun;3(3):247-9
references.pmid: 8347878
references.citation: Am J Surg. 2001 Jun;181(6):547-50
references.pmid: 11513783
references.citation: Surg Endosc. 2002 Mar;16(3):406-11
references.pmid: 11928017
references.citation: Arch Surg. 1999 Mar;134(3):278-81; discussion 282
references.pmid: 10088568
references.citation: Qual Health Care. 2001 Dec;10 Suppl 2:ii64-9
references.pmid: 11700382
references.citation: Surg Endosc. 2002 Sep;16(9):1324-8
references.pmid: 11988802
references.citation: Surg Endosc. 2003 Feb;17(2):212-5
references.pmid: 12457218
references.citation: Semin Laparosc Surg. 2002 Dec;9(4):198-205
references.pmid: 12522776
references.citation: Ann Surg. 2002 Oct;236(4):458-63; discussion 463-4
references.pmid: 12368674