Nicole Santos, BS1, Jamaya Carter, BA2, Fangshu He, MS2, Ali Linsk, MD1, Alyssa Lungarini, MS1, Arun Nemani, PhD3, Ganesh Sankaranarayanan, PhD4, Daniel Jones, MD5, Suvranu De, PhD3, Steven Schwaitzberg, MD6, Caroline G.L. Cao, PhD2. 1Cambridge Health Alliance, 2Wright State University, 3Rensselaer Polytechnic Institute, 4Baylor University Medical Center, 5Beth Israel Deaconess Medical Center, 6University at Buffalo
Background: Minimally invasive surgeries are in high demand since it reduces post-operative pain, scarring, and hospital visits. Training with simulators is becoming a standard approach for teaching surgical skills in the lab before going into the operating room. The Virtual Translumenal Endoscopic Surgery Trainer (VTEST) is a virtual reality system for training skills in the hybrid-NOTES technique. It was used to evaluate the learning curve of novices in a NOTES cholecystectomy procedure.
Methods: Twenty medical students were randomly assigned to a control group or a training group (10 each). All subjects performed the cholecystectomy procedure on the VTEST to establish a baseline (pre-test). The training group received 15 training sessions, over a period of 3 consecutive weeks, consisting of 5 trials per session or as many trials as can be accomplished in an hour, whichever was achieved first. At the end of the training period, all subjects performed one trial on the simulator (post-test), and returned 2 to 3 weeks later to perform a retention test trial. Performance data including completion time, injuries, total score, and CUSUM (cumulative summation scores relative to an expert surgeon of NOTES) were analyzed.
Results: The learning curve results showed that subjects in the training group performed significantly better than those in the control group in completion time, injuries, and total score. This training advantage was evident in post-test, as well as retention test. CUSUM results showed that only one training subject crossed the h1 line (proficiency) but not the h0 line. The other 9 subjects in the training group did not reach the expert proficiency score (154).
Conclusions: Although not all training subjects reached proficiency, the training group did show significantly improved performance over the control group, and were able to retain the skill after at least 2 weeks of non-use. The VTEST Simulator is thus a useful tool to provide training and retention of skills for novice learners.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80250
Program Number: P306
Presentation Session: Poster (Non CME)
Presentation Type: Poster