title: The value of virtual reality-simulator training in the development of laparoscopic surgical skills.
abstract: OBJECTIVE
  To determine the effectiveness of virtual reality (VR) training in improving the surgical skills of medical students and gynecologic trainees.
  
  
  METHODS
  A prospective observational study to assess the changes observed in objectively measured surgical performance after VR training.
  
  
  METHODS
  University teaching hospital and the laboratories of the University of Western Australia.
  
  
  METHODS
  Fifteen 5th-year medical students, six junior-doctor trainees (years 1-3), and eight senior trainees (years 4-6).
  
  
  METHODS
  Standard gynecologic procedures before and after VR training were undertaken on sheep. The procedures were video-recorded and edited to blind the scorer as to identity and seniority of the operator. The procedures were scored using a combination of operative time and penalties for surgical errors. The surgical scores were correlated with the VR scores.
  
  
  RESULTS
  Operative skills were assessed using a combination score compiled from scores obtained while undertaking salpingectomy, salpingotomy, and tubal clipping. Virtual reality scores were also a combination score derived from summation of various computer-calculated measures of time and accuracy in undertaking two standardized exercises.
  
  
  RESULTS
  The baseline VR scores were significantly related to the overall pre-training scores (salpingectomy p = .032). A better initial VR score was also predictive of better surgical performance. The initial VR score was also predictive of improvement observed between baseline and post-training (p = .004).
  
  
  CONCLUSIONS
  Virtual reality training is of value in improving surgical skills in the clinical environment. It appears to be of most value in the earliest stages of training. These data suggest that serious consideration should be given to incorporating VR training into the training program of obstetricians and gynecologists at an early stage.
authors.affiliation: UWA School of Women's and Infants' Health, University of Western Australia, Perth, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Hart
authors.forename: Dorota A
authors.initials: DA
authors.lastname: Doherty
authors.forename: Krishnan
authors.initials: K
authors.lastname: Karthigasu
authors.forename: Raymond
authors.initials: R
authors.lastname: Garry
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001315:Australia; D002983:Clinical Competence; D015331:Cohort Studies; D004503:Education, Medical, Graduate / Q000379:methods; D004504:Education, Medical, Undergraduate / Q000379:methods; D018961:Educational Technology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008505:Medical Staff, Hospital; D011336:Probability; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013337:Students, Medical; D014584:User-Computer Interface