Implementation of laparoscopic virtual-reality simulation training in gynaecology: a mixed-methods design.
OBJECTIVE
Virtual-reality (VR) training has been demonstrated to improve laparoscopic surgical skills in the operating theatre. The incorporation of laparoscopic VR simulation into surgical training in gynaecology remains a significant educational challenge. We undertook a pilot study to assess the feasibility of the implementation of a laparoscopic VR simulation programme into a single unit.


METHODS
An observational study with qualitative analysis of semi-structured group interviews. Trainees in gynaecology (n=9) were scheduled to undertake a pre-validated structured training programme on a laparoscopic VR simulator (LapSim(®)) over six months. The main outcome measure was the trainees' progress through the training modules in six months. Trainees' perceptions of the feasibility and barriers to the implementation of laparoscopic VR training were assessed in focus groups after training.


RESULTS
Sixty-six percent of participants completed six of ten modules. Overall, feedback from the focus groups was positive; trainees felt training improved their dexterity, hand-eye co-ordination and confidence in theatre. Negative aspects included lack of haptic feedback, and facility for laparoscopic port placement training. Time restriction emerged as the main barrier to training.


CONCLUSIONS
Despite positive perceptions of training, no trainee completed more than two-thirds of the modules of a self-directed laparoscopic VR training programme. Suggested improvements to the integration of future laparoscopic VR training include an additional theoretical component with a fuller understanding of benefits of VR training, and scheduled supervision. Ultimately, the success of a laparoscopic VR simulation training programme might only be improved if it is a mandatory component of the curriculum, together with dedicated time for training. Future multi-centred implementation studies of validated laparoscopic VR curricula are required.
The Womens' Centre, Gloucestershire Hospital, Great Western Road, Gloucestershire GL1 3NN, UK; Research into Safety and Quality (RiSQ), Southmead Hospital, Westbury on Trym, Bristol BS10 5NB, UK. Electronic address: christyburden@hotmail.com.
Christy
C
Burden
Tracy-Louise
TL
Appleyard
Jo
J
Angouri
Timothy J
TJ
Draycott
Leanne
L
McDermott
Robert
R
Fox
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000193:education* / Q000379:methods*; D006176:Gynecology / Q000193:education* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000379:methods*; D014584:User-Computer Interface
Curriculum; Education; Laparoscopic; Simulation; Training; Virtual reality