title: Virtual reality does not meet expectations in a pilot study on multimodal laparoscopic surgery training.
abstract: BACKGROUND
  The purpose of the present study was to determine the value of virtual reality (VR) training for a multimodality training program of basic laparoscopic surgery.
  
  
  METHODS
  Participants in a two-day multimodality training for laparoscopic surgery used box trainers, live animal training, and cadaveric training on the pulsating organ perfusion (POP) trainer in a structured and standardized training program. The participants were divided into two groups. The VR group (n = 13) also practiced with VR training during the program, whereas the control group (n = 14) did not use VR training. The training modalities were assessed using questionnaires with a five-point Likert scale after the program. Concerning VR training, members of the control group assessed their expectations, whereas the VR group assessed the actual experience of using it. Skills performance was evaluated with five standardized test tasks in a live porcine model before (pre-test) and after (post-test) the training program. Laparoscopic skills were measured by task completion time and a general performance score for each task. Baseline tests were compared with laparoscopic experience of all participants for construct validity of the skills test.
  
  
  RESULTS
  The expected benefit from VR training of the control group was higher than the experienced benefit of the VR group. Box and POP training received better ratings from the VR group than from the control group for some purposes. Both groups improved their skill parameters significantly from pre-training to post-training tests [score +17 % (P < 0.01), time -29 % (P < 0.01)]. No significant difference was found between the two groups for laparoscopic skills improvement except for the score in the instrument coordination task. Construct validity of the skills test was significant for both time and score.
  
  
  CONCLUSIONS
  At its current level of performance, VR training does not meet expectations. No additional benefit was observed from VR training in our multimodality training program.
authors: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. felix.nickel@med.uni-heidelberg.de
authors: Felix
authors: F
authors: Nickel
authors: Vasile V
authors: VV
authors: Bintintan
authors: Tobias
authors: T
authors: Gehrig
authors: Hannes G
authors: HG
authors: Kenngott
authors: Lars
authors: L
authors: Fischer
authors: Carsten N
authors: CN
authors: Gutt
authors: Beat P
authors: BP
authors: Müller-Stich
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004502:Education, Medical, Continuing; D005257:Fellowships and Scholarships; D005762:Gastroenterology / Q000193:education; D005858:Germany; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D017145:Models, Educational; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D014584:User-Computer Interface