Feasibility, effectiveness and transferability of a novel mastery-based virtual reality robotic training platform for general surgery residents
Background The annual number of robotic surgical procedures is on the rise. Robotic surgery requires unique skills compared to other surgical approaches. Simulation allows basic robot skill acquisition and enhances patient safety. The purpose of this study was to evaluate the feasibility, effectiven...
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| Veröffentlicht in: | Surgical endoscopy 2022-10, Vol.36 (10), p.7279-7287 |
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| creator | Radi, Imad Tellez, Juan C. Alterio, Rodrigo E. Scott, Daniel J. Sankaranarayanan, Ganesh Nagaraj, Madhuri B. Hogg, Melissa E. Zeh, Herbert J. Polanco, Patricio M. |
| description | Background
The annual number of robotic surgical procedures is on the rise. Robotic surgery requires unique skills compared to other surgical approaches. Simulation allows basic robot skill acquisition and enhances patient safety. The purpose of this study was to evaluate the feasibility, effectiveness, and transferability of a mastery-based curriculum using a new virtual reality (VR) robotic simulator for surgery resident training.
Methods
Nineteen PGY2s and 22 PGY4s were enrolled. Residents completed a pretest and posttest consisting of five VR and three previously validated inanimate tasks. Training included practicing 33 VR tasks until a total score ≥ 90% (“mastery”) was achieved using automated metrics (time, economy of motion). Inanimate performance was evaluated by two trained, blinded raters using video review metrics (time, errors, and modified OSATS). Outcomes were defined as: curriculum feasibility (completion rate, training time, repetitions), training effectiveness (pre/post training skill improvement), and skill transferability (skill transfer to validated inanimate drills). Wilcoxon signed-rank and Mann–Whitney
U
tests were used; median (IQR) reported.
Results
Thirty-four of 41 residents (83%) achieved mastery on all 33 VR tasks; median training time was 7 h (IQR: 5′26″–8′52″). Pretest vs. post-test performance improved (all
p
|
| doi_str_mv | 10.1007/s00464-022-09106-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8863393</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2632147438</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-5d8eb9046d95167115feb9774118bc66e55c78d387c00f9a48cce1eebb0312a93</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhS0EopfCC7BAltiwIOCfxLE3SFVFAakSG1hbjjO5uMq1L7ZzpduX4JWZNqX8LNjYsuabc2Z8CHnO2RvOWP-2MNaqtmFCNMxwpprrB2TDWykaIbh-SDbMSNaI3rQn5EkpVwx5w7vH5ER23LRKiQ35cQGuhCHMoR5fU5gm8DUcIEIp1MWR1uximSC7FaFpoo7GdICZ7lypkI_N4AqM9BByXdxMM7hbMKch1eBvBEIMcUv3s6tTyjuKB92iQ0a6LHmLGthVwgixlqfk0eTmAs_u7lPy9eL9l_OPzeXnD5_Ozy4b3_ZtbbpRw2Bw_dF0XPWcdxO--77lXA9eKeg63-tR6t4zNhnXau-BAwwDk1w4I0_Ju1V3vww7GD164zx2n8PO5aNNLti_KzF8s9t0sForKY1EgVd3Ajl9X6BUuwvFwzy7CGkpVigpOM4qNaIv_0Gv0pIjrmdFzzvFtVQdUmKlfE6lZJjuh-HM3uRt17wt5m1v87bX2PTizzXuW34FjIBcgYKliH_92_s_sj8BKSq7PA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2715618365</pqid></control><display><type>article</type><title>Feasibility, effectiveness and transferability of a novel mastery-based virtual reality robotic training platform for general surgery residents</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Radi, Imad ; Tellez, Juan C. ; Alterio, Rodrigo E. ; Scott, Daniel J. ; Sankaranarayanan, Ganesh ; Nagaraj, Madhuri B. ; Hogg, Melissa E. ; Zeh, Herbert J. ; Polanco, Patricio M.</creator><creatorcontrib>Radi, Imad ; Tellez, Juan C. ; Alterio, Rodrigo E. ; Scott, Daniel J. ; Sankaranarayanan, Ganesh ; Nagaraj, Madhuri B. ; Hogg, Melissa E. ; Zeh, Herbert J. ; Polanco, Patricio M.</creatorcontrib><description>Background
The annual number of robotic surgical procedures is on the rise. Robotic surgery requires unique skills compared to other surgical approaches. Simulation allows basic robot skill acquisition and enhances patient safety. The purpose of this study was to evaluate the feasibility, effectiveness, and transferability of a mastery-based curriculum using a new virtual reality (VR) robotic simulator for surgery resident training.
Methods
Nineteen PGY2s and 22 PGY4s were enrolled. Residents completed a pretest and posttest consisting of five VR and three previously validated inanimate tasks. Training included practicing 33 VR tasks until a total score ≥ 90% (“mastery”) was achieved using automated metrics (time, economy of motion). Inanimate performance was evaluated by two trained, blinded raters using video review metrics (time, errors, and modified OSATS). Outcomes were defined as: curriculum feasibility (completion rate, training time, repetitions), training effectiveness (pre/post training skill improvement), and skill transferability (skill transfer to validated inanimate drills). Wilcoxon signed-rank and Mann–Whitney
U
tests were used; median (IQR) reported.
Results
Thirty-four of 41 residents (83%) achieved mastery on all 33 VR tasks; median training time was 7 h (IQR: 5′26″–8′52″). Pretest vs. post-test performance improved (all
p
< 0.001) according to all VR and Inanimate metrics for both PGY2 and PGY4 residents. Significant pretest performance differences were observed between PGY2 and PGY4 residents for VR but not inanimate tasks; no PGY2 vs. PGY4 posttest performance differences were observed for both VR and inanimate tasks.
Conclusion
This mastery-based VR curriculum was associated with a high completion rate and excellent feasibility. Significant performance improvements were noted for both the VR and inanimate tasks, supporting training effectiveness and skill transferability. Additional studies examining validity evidence may help further refine this curriculum.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-022-09106-z</identifier><identifier>PMID: 35194662</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Clinical Competence ; Computer Simulation ; Curriculum ; Design ; Endoscopy ; Feasibility Studies ; Gastroenterology ; General Surgery - education ; Gynecology ; Hepatology ; Humans ; Internship and Residency ; Laparoscopy ; Medical education ; Medical residencies ; Medicine ; Medicine & Public Health ; Patient safety ; Proctology ; Robotic surgery ; Robotic Surgical Procedures - education ; Robotics - education ; Simulation ; Simulation Training - methods ; Skills ; Software ; Surgery ; Virtual Reality</subject><ispartof>Surgical endoscopy, 2022-10, Vol.36 (10), p.7279-7287</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-5d8eb9046d95167115feb9774118bc66e55c78d387c00f9a48cce1eebb0312a93</citedby><cites>FETCH-LOGICAL-c474t-5d8eb9046d95167115feb9774118bc66e55c78d387c00f9a48cce1eebb0312a93</cites><orcidid>0000-0002-1719-1208</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-022-09106-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-022-09106-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35194662$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Radi, Imad</creatorcontrib><creatorcontrib>Tellez, Juan C.</creatorcontrib><creatorcontrib>Alterio, Rodrigo E.</creatorcontrib><creatorcontrib>Scott, Daniel J.</creatorcontrib><creatorcontrib>Sankaranarayanan, Ganesh</creatorcontrib><creatorcontrib>Nagaraj, Madhuri B.</creatorcontrib><creatorcontrib>Hogg, Melissa E.</creatorcontrib><creatorcontrib>Zeh, Herbert J.</creatorcontrib><creatorcontrib>Polanco, Patricio M.</creatorcontrib><title>Feasibility, effectiveness and transferability of a novel mastery-based virtual reality robotic training platform for general surgery residents</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
The annual number of robotic surgical procedures is on the rise. Robotic surgery requires unique skills compared to other surgical approaches. Simulation allows basic robot skill acquisition and enhances patient safety. The purpose of this study was to evaluate the feasibility, effectiveness, and transferability of a mastery-based curriculum using a new virtual reality (VR) robotic simulator for surgery resident training.
Methods
Nineteen PGY2s and 22 PGY4s were enrolled. Residents completed a pretest and posttest consisting of five VR and three previously validated inanimate tasks. Training included practicing 33 VR tasks until a total score ≥ 90% (“mastery”) was achieved using automated metrics (time, economy of motion). Inanimate performance was evaluated by two trained, blinded raters using video review metrics (time, errors, and modified OSATS). Outcomes were defined as: curriculum feasibility (completion rate, training time, repetitions), training effectiveness (pre/post training skill improvement), and skill transferability (skill transfer to validated inanimate drills). Wilcoxon signed-rank and Mann–Whitney
U
tests were used; median (IQR) reported.
Results
Thirty-four of 41 residents (83%) achieved mastery on all 33 VR tasks; median training time was 7 h (IQR: 5′26″–8′52″). Pretest vs. post-test performance improved (all
p
< 0.001) according to all VR and Inanimate metrics for both PGY2 and PGY4 residents. Significant pretest performance differences were observed between PGY2 and PGY4 residents for VR but not inanimate tasks; no PGY2 vs. PGY4 posttest performance differences were observed for both VR and inanimate tasks.
Conclusion
This mastery-based VR curriculum was associated with a high completion rate and excellent feasibility. Significant performance improvements were noted for both the VR and inanimate tasks, supporting training effectiveness and skill transferability. Additional studies examining validity evidence may help further refine this curriculum.</description><subject>Abdominal Surgery</subject><subject>Clinical Competence</subject><subject>Computer Simulation</subject><subject>Curriculum</subject><subject>Design</subject><subject>Endoscopy</subject><subject>Feasibility Studies</subject><subject>Gastroenterology</subject><subject>General Surgery - education</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Internship and Residency</subject><subject>Laparoscopy</subject><subject>Medical education</subject><subject>Medical residencies</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patient safety</subject><subject>Proctology</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - education</subject><subject>Robotics - education</subject><subject>Simulation</subject><subject>Simulation Training - methods</subject><subject>Skills</subject><subject>Software</subject><subject>Surgery</subject><subject>Virtual Reality</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc1u1TAQhS0EopfCC7BAltiwIOCfxLE3SFVFAakSG1hbjjO5uMq1L7ZzpduX4JWZNqX8LNjYsuabc2Z8CHnO2RvOWP-2MNaqtmFCNMxwpprrB2TDWykaIbh-SDbMSNaI3rQn5EkpVwx5w7vH5ER23LRKiQ35cQGuhCHMoR5fU5gm8DUcIEIp1MWR1uximSC7FaFpoo7GdICZ7lypkI_N4AqM9BByXdxMM7hbMKch1eBvBEIMcUv3s6tTyjuKB92iQ0a6LHmLGthVwgixlqfk0eTmAs_u7lPy9eL9l_OPzeXnD5_Ozy4b3_ZtbbpRw2Bw_dF0XPWcdxO--77lXA9eKeg63-tR6t4zNhnXau-BAwwDk1w4I0_Ju1V3vww7GD164zx2n8PO5aNNLti_KzF8s9t0sForKY1EgVd3Ajl9X6BUuwvFwzy7CGkpVigpOM4qNaIv_0Gv0pIjrmdFzzvFtVQdUmKlfE6lZJjuh-HM3uRt17wt5m1v87bX2PTizzXuW34FjIBcgYKliH_92_s_sj8BKSq7PA</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Radi, Imad</creator><creator>Tellez, Juan C.</creator><creator>Alterio, Rodrigo E.</creator><creator>Scott, Daniel J.</creator><creator>Sankaranarayanan, Ganesh</creator><creator>Nagaraj, Madhuri B.</creator><creator>Hogg, Melissa E.</creator><creator>Zeh, Herbert J.</creator><creator>Polanco, Patricio M.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1719-1208</orcidid></search><sort><creationdate>20221001</creationdate><title>Feasibility, effectiveness and transferability of a novel mastery-based virtual reality robotic training platform for general surgery residents</title><author>Radi, Imad ; Tellez, Juan C. ; Alterio, Rodrigo E. ; Scott, Daniel J. ; Sankaranarayanan, Ganesh ; Nagaraj, Madhuri B. ; Hogg, Melissa E. ; Zeh, Herbert J. ; Polanco, Patricio M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-5d8eb9046d95167115feb9774118bc66e55c78d387c00f9a48cce1eebb0312a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal Surgery</topic><topic>Clinical Competence</topic><topic>Computer Simulation</topic><topic>Curriculum</topic><topic>Design</topic><topic>Endoscopy</topic><topic>Feasibility Studies</topic><topic>Gastroenterology</topic><topic>General Surgery - education</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Internship and Residency</topic><topic>Laparoscopy</topic><topic>Medical education</topic><topic>Medical residencies</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patient safety</topic><topic>Proctology</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - education</topic><topic>Robotics - education</topic><topic>Simulation</topic><topic>Simulation Training - methods</topic><topic>Skills</topic><topic>Software</topic><topic>Surgery</topic><topic>Virtual Reality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Radi, Imad</creatorcontrib><creatorcontrib>Tellez, Juan C.</creatorcontrib><creatorcontrib>Alterio, Rodrigo E.</creatorcontrib><creatorcontrib>Scott, Daniel J.</creatorcontrib><creatorcontrib>Sankaranarayanan, Ganesh</creatorcontrib><creatorcontrib>Nagaraj, Madhuri B.</creatorcontrib><creatorcontrib>Hogg, Melissa E.</creatorcontrib><creatorcontrib>Zeh, Herbert J.</creatorcontrib><creatorcontrib>Polanco, Patricio M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Radi, Imad</au><au>Tellez, Juan C.</au><au>Alterio, Rodrigo E.</au><au>Scott, Daniel J.</au><au>Sankaranarayanan, Ganesh</au><au>Nagaraj, Madhuri B.</au><au>Hogg, Melissa E.</au><au>Zeh, Herbert J.</au><au>Polanco, Patricio M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility, effectiveness and transferability of a novel mastery-based virtual reality robotic training platform for general surgery residents</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2022-10-01</date><risdate>2022</risdate><volume>36</volume><issue>10</issue><spage>7279</spage><epage>7287</epage><pages>7279-7287</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
The annual number of robotic surgical procedures is on the rise. Robotic surgery requires unique skills compared to other surgical approaches. Simulation allows basic robot skill acquisition and enhances patient safety. The purpose of this study was to evaluate the feasibility, effectiveness, and transferability of a mastery-based curriculum using a new virtual reality (VR) robotic simulator for surgery resident training.
Methods
Nineteen PGY2s and 22 PGY4s were enrolled. Residents completed a pretest and posttest consisting of five VR and three previously validated inanimate tasks. Training included practicing 33 VR tasks until a total score ≥ 90% (“mastery”) was achieved using automated metrics (time, economy of motion). Inanimate performance was evaluated by two trained, blinded raters using video review metrics (time, errors, and modified OSATS). Outcomes were defined as: curriculum feasibility (completion rate, training time, repetitions), training effectiveness (pre/post training skill improvement), and skill transferability (skill transfer to validated inanimate drills). Wilcoxon signed-rank and Mann–Whitney
U
tests were used; median (IQR) reported.
Results
Thirty-four of 41 residents (83%) achieved mastery on all 33 VR tasks; median training time was 7 h (IQR: 5′26″–8′52″). Pretest vs. post-test performance improved (all
p
< 0.001) according to all VR and Inanimate metrics for both PGY2 and PGY4 residents. Significant pretest performance differences were observed between PGY2 and PGY4 residents for VR but not inanimate tasks; no PGY2 vs. PGY4 posttest performance differences were observed for both VR and inanimate tasks.
Conclusion
This mastery-based VR curriculum was associated with a high completion rate and excellent feasibility. Significant performance improvements were noted for both the VR and inanimate tasks, supporting training effectiveness and skill transferability. Additional studies examining validity evidence may help further refine this curriculum.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35194662</pmid><doi>10.1007/s00464-022-09106-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1719-1208</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Surgical endoscopy, 2022-10, Vol.36 (10), p.7279-7287 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Clinical Competence Computer Simulation Curriculum Design Endoscopy Feasibility Studies Gastroenterology General Surgery - education Gynecology Hepatology Humans Internship and Residency Laparoscopy Medical education Medical residencies Medicine Medicine & Public Health Patient safety Proctology Robotic surgery Robotic Surgical Procedures - education Robotics - education Simulation Simulation Training - methods Skills Software Surgery Virtual Reality |
| title | Feasibility, effectiveness and transferability of a novel mastery-based virtual reality robotic training platform for general surgery residents |
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