title: "Alarm-corrected" ergonomic armrest use could improve learning curves of novices on robotic simulator.
abstract: In robotic surgery, the professional ergonomic habit of using an armrest reduces operator fatigue and increases the precision of motion. We designed and validated a pressure surveillance system (PSS) based on force sensors to investigate armrest use. The objective was to evaluate whether adding an alarm to the PSS system could shorten ergonomic training and improve performance.
  
  
  
  Twenty robot and simulator-naïve participants were recruited and randomized in two groups (A and B). The PSS was installed on a robotic simulator, the dV-Trainer, to detect contact with the armrest. The Group A members completed three tasks on the dV-Trainer without the alarm, making 15 attempts at each task. The Group B members practiced the first two tasks with the alarm and then completed the final tasks without the alarm. The simulator provided an overall score reflecting the trainees' performance. We used the new concept of an "armrest load" score to describe the ergonomic habit of using the armrest.
  
  
  
  Group B had a significantly higher performance score (p < 0.001) and armrest load score (p < 0.001) than Group A from the fifth attempt of the first task to the end of the experiment.
  
  
  
  Based on the conditioned reflex effect, the alarm associated with the PSS rectified ergonomic errors and accelerated professional ergonomic habit acquisition. The combination of the PSS and alarm is effective in significantly shortening the learning curve in the robotic training process.
authors.affiliation: IADI/Inserm U947, Lorraine University, 54000, Nancy, France.|Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, 430071, China.|Department of Urology, University Hospital of Nancy, allée du Morvan, 54511, Vandœuvre les Nancy, France.
authors.forename: Kun
authors.initials: K
authors.lastname: Yang
authors.affiliation: IADI/Inserm U947, Lorraine University, 54000, Nancy, France.|Department of Emergency and General Surgery, CHU Nancy, 54000, Nancy, France.
authors.forename: Manuela
authors.initials: M
authors.lastname: Perez
authors.affiliation: IADI/Inserm U947, Lorraine University, 54000, Nancy, France.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Hossu
authors.affiliation: IADI/Inserm U947, Lorraine University, 54000, Nancy, France.|Department of Urology, University Hospital of Nancy, allée du Morvan, 54511, Vandœuvre les Nancy, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Hubert
authors.affiliation: IADI/Inserm U947, Lorraine University, 54000, Nancy, France.|Department of Emergency and General Surgery, CHU Nancy, 54000, Nancy, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Perrenot
authors.affiliation: IADI/Inserm U947, Lorraine University, 54000, Nancy, France. j.hubert@chu-nancy.fr.|Department of Urology, University Hospital of Nancy, allée du Morvan, 54511, Vandœuvre les Nancy, France. j.hubert@chu-nancy.fr.
authors.forename: Jacques
authors.initials: J
authors.lastname: Hubert
mesh_terms: D000328:Adult; D001132:Arm; D002983:Clinical Competence; D006804:Ergonomics; D005260:Female; D005602:France; D006801:Humans; D059032:Learning Curve; D008297:Male; D065287:Robotic Surgical Procedures / Q000193:education* / Q000295:instrumentation*; D000066908:Simulation Training / Q000379:methods*
keywords: Conditioned reflex; Ergonomic; Learning curve; Robotic surgery; Simulation; dV-Trainer