Virtual Reality Surgical Simulation for Arthroscopy Training
Robert A. PedowitzThere is little doubt that the medical profession stands at a major crossroads with regards to the fundamental structure of surgical education. Although the apprenticeship model has been used for centuries, we are rapidly moving toward a new era of proficiencybased education. This transition is motivated by several important factors, including greater emphasis upon patient safety, increased focus on educational efficacy, and a shift toward objectively measured performance outcomes (i.e., demonstration of clinical proficiency). At the same time, the paradigm shift is challenged by limitations imposed by trainee work hour restrictions and by the initial investments and ongoing expenses associated with implementation of new training paradigms.
Which Global Rating Scale? A Comparison of the ASSET, BAKSSS, and IGARS for the Assessment of Simulated Arthroscopic Skills.
Middleton RM, Baldwin MJ, Akhtar K, Alvand A, Rees JLBACKGROUND: With the move to competency-based models of surgical training, a number of assessment methods have been developed. Of these, global rating scales have emerged as popular tools, and several are specific to the assessment of arthroscopic skills. Our aim was to determine which one of a group of commonly used global rating scales demonstrated superiority in the assessment of simulated arthroscopic skills.
Validation of the updated ArthroS simulator: face and construct validity of a passive haptic virtual reality simulator with novel performance metrics
Patrick Garfjeld Roberts, Paul Guyver, Mathew Baldwin, Kash Akhtar, Abtin Alvand, Andrew J. Price, Jonathan L. ReesPurpose: To assess the construct and face validity of ArthroS, a passive haptic VR simulator. A secondary aim was to evaluate the novel performance metrics produced by this simulator.
Operative and diagnostic hysteroscopy: A novel learning model combining new animal models and virtual reality simulation
Alfred Bassil, Chrystèle Rubod, Yves Borghesi, Yohan Kerbage, Elie Servan Schreiber, Henri Azaïs, Charles GarabedianHysteroscopy is one of the most common gynaecological procedure. Training for diagnostic and operative hysteroscopy can be achieved through numerous previously described models like animal models or virtual reality simulation. We present our novel combined model associating virtual reality and bovine uteruses and bladders.
Knee, Shoulder, and Fundamentals of Arthroscopic Surgery Training: Validation of a Virtual Arthroscopy Simulator
Josef N. Tofte, Brian O. Westerlind, Kevin D. Martin, Brian L. Guetschow, Bastián Uribe-Echevarria, Chamnanni Rungprai, Phinit PhisitkulPurpose: To validate the knee, shoulder, and virtual Fundamentals of Arthroscopic Training (FAST) modules on a virtual arthroscopy simulator via correlations with arthroscopy case experience and postgraduate year.
Integration and Validation of Hysteroscopy Simulation in the Surgical Training Curriculum
Mohamed Elessawy, Moritz Skrzipczyk, Christel Eckmann-Scholz, Nicolai Maass, Liselotte Mettler, Veronika Guenther, Marion van Mackelenbergh, Dirk O. Bauerschlag, Ibrahim AlkatoutThe primary objective of our study was to test the construct validity of the HystSim hysteroscopic simulator to determine whether simulation training can improve the acquisition of hysteroscopic skills regardless of the previous levels of experience of the participants. The secondary objective was to analyze the performance of a selected task, using specially designed scoring charts to help reduce the learning curve for both novices and experienced surgeons.
Comparison Of Three Virtual Reality Arthroscopic Simulators As Part Of An Orthopedic Residency Educational Curriculum
Kevin D Martin, DO, MAJ, MC, Craig C Akoh, MD, Annunziato Amendola, MD, Phinit Phisitkul, MDOrthopedic education continues to move towards evidence-based curriculum in order to comply with new residency accreditation mandates. There are currently three high fidelity arthroscopic virtual reality (VR) simulators available, each with multiple instructional modules and simulated arthroscopic procedures. The aim of the current study is to assess face validity, defined as the degree to which a procedure appears effective in terms of its stated aims, of three available VR simulators.
Asymmetry in Dominant / Non-Dominant Hand Performance Differentiates Novices from Experts on an Arthroscopy Virtual Reality Serious Game
Robert PEDOWITZ, MD, PhD, Gregg NICANDRI, MD, and Stefan TUCHSCHMID, PhDSafe and effective arthroscopic surgery requires ambidextrous motor skills. The current study examined dominant versus non-dominant hand performance on a virtual reality serious game in a group of expert arthroscopic surgeons (n=15) compared to a group of orthopedic surgery residents (n=10).
Evaluation of the HystSim™-virtual reality trainer: an essential additional tool to train hysteroscopic skills outside the operation theater
Felix Neis, Sara Brucker, Melanie Henes, F. Andrei Taran, Sascha Hoffmann, Markus Wallwiener, Birgitt Schönfisch, Nicole Ziegler, Angelika Larbig, Rudy Leon De WildeMinimally invasive surgery is a major pillar of gynecological surgery. However, there are very few training opportunities outside the operation theater (OR) due to the cost and equipment requirements of organ simulators, virtual reality trainers (VRT) are promising tools to fill this gap.
Assessment of a high-fidelity mobile simulator for intrauterine contraception training in ambulatory reproductive health centres
Laura E. Dodge, Michele R. Hacker, Sarah H. Averbach, Sara F. Voit and Maureen E. PaulLittle is known about the utility of simulation-based training in office gynaecology. The objective of this cross-sectional study was to evaluate the self-reported effectiveness and acceptability of the PelvicSim™ (VirtaMed), a highfidelity mobile simulator, to train clinicians in intrauterine device (IUD) insertion.
Validation of a virtual reality-based simulator for shoulder arthroscopy
Stefan Rahm, Marco Germann, Andreas Hingsammer, Karl Wieser, Christian GerberThis study was to determine face and construct validity of a new virtual reality-based shoulder arthroscopy simulator which uses passive haptic feedback.
Evaluation of the educational value of a virtual reality TURP simulator according to a curriculum-based approach
Tjiam IM, Berkers CH, Schout BM, Brinkman WM, Witjes JA, Scherpbier AJ, Hendrikx AJ, Koldewijn ELThis study aimed to evaluate the place of the TURPsim (Simbionix/VirtaMed, Beit Goal, Israel) within a urologic residency training curriculum, including training needs analysis (TNA) and investigating its validity.
Advancing Hysteroscopy Skills: Essure® Procedure Virtual Reality Simulator Training
H.W. Schreuder, R.G. Wolswijk, J.E. Persson, I. Ihse, et al.To demonstrate the educational benefits of the Essure® Simulator among physicians seeking to enhance their in-office hysteroscopic skills. The Essure Simulator is a virtual reality-based procedural training platform developed for use on a standard laptop computer. This technology monitors, and realistically simulates, the Essure procedure and offers physicians an innovative teaching opportunity.
A virtual reality simulator for hysteroscopic placement of tubal sterilization micro-inserts: the face and construct validity
J.A. Janse, S. Veersema, F. Broekmans, H.W.R. SchreuderThis study investigated the validity of a virtual reality simulator for hysteroscopic tubal sterilization. Initially performed laparoscopically, the hysteroscopic sterilization method is becoming increasingly popular. An adequate training model could enhance one’s skills prior to the start of performing the procedure on the real patient.
Hysteroscopic Sterilization Using a Virtual Reality Simulator: Assessment of Learning Curve
J.A. Janse, S. Veersema, F. Broekmans, H.W.R. SchreuderThe learning curve is represented by improvement per procedure. Two-way repeatedmeasures analysis of variance was used to analyze learning curves. Effect size (ES) was calculated to express the practical significance of the results (ES R 0.50 indicates a large learning effect). For all parameters, significant improvements were found in novice performance within nine repetitions. Large learning effects were established for six of eight parameters (p , .001; ES, 0.50–0.96). Novices approached expert level within 9 to 14 repetitions. The learning curve established in this study endorses future implementation of the simulator in curricula on hysteroscopic skill acquisition for clinicians who are interested in learning this sterilization technique.
Hysteroscopic Placement of Tubal Sterilization Implants: Virtual Reality Simulator Training
Panel P, Bajka M, Cotin S.Responses to realism, educational potential and general opinion were excellent, proving face validity. Significant differences between novices and experts were assessed for 7 of the 15 metrics analyzed, proving construct validity.
Effectiveness of Simulation Training in Improving the Operative Performance of the Essure® Procedure
Chavan NR, Santandreu O, Jacobs AJ. Dept. of Obstetrics & Gynecology, Flushing Hospital Medical Center, Flushing, New YorkWe prospectively followed two consecutive cohorts of patients undergoing the Essure® procedure over a 1 year period from Feb’11 through Jan’12 - 58 cases before and 78 cases after implementation of the EssureSim™ (VirtaMed AG, Switzerland) simulation program, among residents (n = 14) and attending physicians (n = 44). The time to deployment (time from entering endocervical canal to microinsert placement) was significantly shorter after simulation training, as was the total operating room (OR) time. These cases had a significantly lower frequency of requiring > 2 essure coils for successful insertion.
Evaluation of a New Virtual-Reality Training Simulator for Hysteroscopy
PD Dr. med. Michael Bajka, Dr. Stefan Tuchschmid, Daniel Fink, Prof. Dr. Gabor Szekely, PD Dr. Matthias HardersFace validity has been established for a new hysteroscopic surgery simulator. Potential trainees and trainers assess it to be a realistic and useful tool for the training of hysteroscopy. Further systematic validation studies are needed to clarify how this system can be optimally integrated into the gynecological curriculum.
Establishing Construct Validity of a Virtual-Reality Training Simulator for hysteroscopy via a Multimetric Scoring System
PD Dr. med. Michael Bajka, Dr. Stefan Tuchschmid, Daniel Fink, Prof. Dr. Gabor Szekely, PD Dr. Matthias HardersThe aims of this study are to determine construct validity for the HystSim™ virtual reality (VR) training simulator for hysteroscopy via a new multimetric scoring system (MMSS) and to explore learning curves for both novices and experienced surgeons.
Preliminary Experience with Virtual Reality Simulation vs. Animal Model for Hysteroscopic Myomectomy Training
L.R. Glazerman, S.R. Hart, M. Bajka, D. Fink, R.R. BassalyThe HystSim™ Virtual Reality hysteroscopic trainer was felt to be at least equal to the ‘‘gold standard’’ pig bladder model for training in hysteroscopic myomectomy with the additional advantages of reproducibility and measurement of results. Further studies comparing modalities and relating results to operating room performance are warranted.