Format

Send to

Choose Destination
See comment in PubMed Commons below
J Surg Educ. 2014 Jan-Feb;71(1):125-32. doi: 10.1016/j.jsurg.2013.06.009. Epub 2013 Jul 12.

Virtual reality robotic surgical simulation: an analysis of gynecology trainees.

Author information

1
Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, Maryland.
2
Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, Maryland; Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, Greater Baltimore Medical Center, Baltimore, Maryland.
3
Department of Gynecology and Obstetrics, Johns Hopkins Medical Institutions, Baltimore, Maryland. Electronic address: igreen5@jhmi.edu.

Abstract

STUDY OBJECTIVE:

To analyze the learning curves of gynecology trainees on several virtual reality da Vinci Skills Simulator exercises.

DESIGN:

Prospective cohort pilot study.

SETTING:

Academic hospital-based gynecology training program.

PARTICIPANTS:

Novice robotic surgeons from a gynecology training program.

METHODS:

Novice robotic surgeons from an academic gynecology training program completed 10 repetitions of 4 exercises on the da Vinci Skills Simulator: matchboard, ring and rail, suture sponge, and energy switching. Performance metrics measured included time to completion, economy of instrument movement, excessive force, collisions, master workspace range, missed targets, misapplied energy, critical errors, and overall score. Statistical analyses were conducted to define the learning curve for trainees and the optimal number of repetitions for each exercise.

RESULTS:

A total of 34 participants were enrolled, of which 9 were medical students, 22 were residents, and 3 were fellows. There was a significant improvement in performance between the 1st and 10th repetitions across multiple metrics for all exercises. Senior trainees performed the suture exercise significantly faster than the junior trainees during the first and last repetitions (p = 0.004 and p = 0.003, respectively). However, the performance gap between seniors and juniors narrowed significantly by the 10th repetition. The mean number of repetitions required to achieve performance plateau ranged from 6.4 to 9.3.

CONCLUSION:

Virtual reality robotic simulation improves ability through repetition at all levels of training. Further, a performance plateau may exist during a single training session. Larger studies are needed to further define the most high-yield simulator exercises, the ideal number of repetitions, and recommended intervals between training sessions to improve operative performance.

KEYWORDS:

Patient Care; Practice-Based Learning and Improvement; computer simulation; gynecologic surgery; minimally invasive/education; robotics; surgical procedures

PMID:
24411435
DOI:
10.1016/j.jsurg.2013.06.009
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center