Randomized controlled trial of virtual reality simulator training: transfer to live patients.
BACKGROUND
New Residency Review Committee requirements in general surgery require 50 colonoscopies. Simulators have been widely suggested to help prepare residents for live clinical experience. We assessed a computer-based colonoscopy simulator for effective transfer of skills to live patients.


METHODS
A randomized controlled trial included general surgery and internal medicine residents with limited endoscopic experience. Following a pretest, the treatment group (n = 12) practiced on the simulator, while controls (n = 12) received no additional training. Both groups then performed a colonoscopy on a live patient. Technical ability was evaluated by expert endoscopists using previously validated assessment instruments.


RESULTS
In the live patient setting, the treatment group scored significantly higher global ratings than controls (t(22) = 1.84, P = .04). Only 2 of the 8 computer-based performance metrics correlated significantly with previously validated global ratings of performance.


CONCLUSIONS
Residents trained on a colonoscopy simulator prior to their first patient-based colonoscopy performed significantly better in the clinical setting than controls, demonstrating skill transfer to live patients. The simulator's performance metrics showed limited concurrent validity, suggesting the need for further refinement.
Park
Jason
J
Faculty of Medicine, Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth St, 1ES-565, Toronto, Ontario, Canada M5G 2C4.
MacRae
Helen
H
Musselman
Laura J
LJ
Rossos
Peter
P
Hamstra
Stanley J
SJ
Wolman
Stephen
S
Reznick
Richard K
RK
D002983:Clinical Competence; D003113:Colonoscopy; D003194:Computer-Assisted Instruction; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D011214:Practice, Psychological; D015203:Reproducibility of Results; D014584:User-Computer Interface