title: Training to acquire psychomotor skills for endoscopic endonasal surgery using a personal webcam trainer.
abstract: OBJECTIVE
  Existing training methods for neuroendoscopic surgery have mainly emphasized the acquisition of anatomical knowledge and procedures for operating an endoscope and instruments. For laparoscopic surgery, various training systems have been developed to teach handling of an endoscope as well as the manipulation of instruments for speedy and precise endoscopic performance using both hands. In endoscopic endonasal surgery (EES), especially using a binostril approach to the skull base and intradural lesions, the learning of more meticulous manipulation of instruments is mandatory, and it may be necessary to develop another type of training method for acquiring psychomotor skills for EES. Authors of the present study developed an inexpensive, portable personal trainer using a webcam and objectively evaluated its utility.
  
  
  METHODS
  Twenty-five neurosurgeons volunteered for this study and were divided into 2 groups, a novice group (19 neurosurgeons) and an experienced group (6 neurosurgeons). Before and after the exercises of set tasks with a webcam box trainer, the basic endoscopic skills of each participant were objectively assessed using the virtual reality simulator (LapSim) while executing 2 virtual tasks: grasping and instrument navigation. Scores for the following 11 performance variables were recorded: instrument time, instrument misses, instrument path length, and instrument angular path (all of which were measured in both hands), as well as tissue damage, max damage, and finally overall score. Instrument time was indicated as movement speed; instrument path length and instrument angular path as movement efficiency; and instrument misses, tissue damage, and max damage as movement precision.
  
  
  RESULTS
  In the novice group, movement speed and efficiency were significantly improved after the training. In the experienced group, significant improvement was not shown in the majority of virtual tasks. Before the training, significantly greater movement speed and efficiency were demonstrated in the experienced group, but no difference in movement precision was shown between the 2 groups. After the training, no significant differences were shown between the 2 groups in the majority of the virtual tasks. Analysis revealed that the webcam trainer improved the basic skills of the novices, increasing movement speed and efficiency without sacrificing movement precision.
  
  
  CONCLUSIONS
  Novices using this unique webcam trainer showed improvement in psychomotor skills for EES. The authors believe that training in terms of basic endoscopic skills is meaningful and that the webcam training system can play a role in daily off-the-job training for EES.
authors: Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors: Ryuichi
authors: R
authors: Hirayama
authors: Yasunori
authors: Y
authors: Fujimoto
authors: Masao
authors: M
authors: Umegaki
authors: Naoki
authors: N
authors: Kagawa
authors: Manabu
authors: M
authors: Kinoshita
authors: Naoya
authors: N
authors: Hashimoto
authors: Toshiki
authors: T
authors: Yoshimine
mesh_terms: D000328:Adult; D004502:Education, Medical, Continuing / Q000379:methods; D004724:Endoscopy / Q000193:education* / Q000379:methods; D006801:Humans; D008297:Male; D008838:Microcomputers; D059747:Nasal Surgical Procedures / Q000193:education* / Q000379:methods; D019635:Neurosurgical Procedures / Q000193:education* / Q000379:methods; D011361:Professional Competence; D011597:Psychomotor Performance / Q000502:physiology*; D013647:Task Performance and Analysis; D013997:Time Factors; D014584:User-Computer Interface; D057211:Webcasts as Topic