Michael Russo, MD, Angelina Vera, Adnan Mohsin, Shawn Tsuda, MD
University of Nevada
Introduction: Laparoscopic skills training has evolved over recent years. However, traditional mentoring (TM) still engages verbal and visual cues which may distract or confuse the learner. To facilitate laparoscopic skill transference, an Augmented Reality Telementoring (ART) Platform was designed to overlay the instruments of a mentor in real-time onto the trainee’s laparoscopic monitor. The aim of this study is to compare the effectiveness of this new teaching modality in novices to traditional methods in performing an intra-corporeal suturing task.
Methods and Procedures: Nineteen pre-medical and medical students (MS1; MS2) were randomized into traditional mentoring (n=9) and ART (n=10) groups for the validated Fundamentals of Laparoscopic Surgery (FLS) Intra-corporeal Suturing Task. Subjects received either TM (scripted verbal cues and pointing to the screen) or ART (scripted verbal cues and digitally overlaid instruments) following a proficiency-based orientation to the FLS Peg Transfer Task. Tasks for suturing were recorded and scored for time and errors. Results were analyzed using means, standard deviation, power regression analysis, correlation coefficient, analysis of variance, and student’s t-test.
Results: Eighteen participants completed the trial. Using Wright’s Cumulative Average Model (Y = aXb), the learning curve slope was significantly steeper, demonstrating faster skill acquisition, for the ART group (b= -0.567, r2=0.92, p=0.0001) than the TM group (b= -0.453, r2=0.74, p=0.003). This difference was greater during the first 4 trials with ART having faster skill acquisition vs. TM (b= -0.484, r2=0.88, p=0.0001 vs. b=-0.342, r2=0.95, p=0.00001). At the end of 10 repetitions or one hour of practice, the ART group was faster vs. TM (mean 167.4s vs. 242.4s, p=0.014). The ART group also had fewer fails (8) than the TM group (13).
Conclusion: The Augmented Reality Telementoring (ART) Platform may be a more effective training technique in teaching laparoscopic skills to novices compared to traditional methods in our simulated study using a validated suturing drill. ART conferred a shorter learning curve, which was more pronounced in the first 4 trials. ART resulted in faster suturing times and reduced number of failed attempts by the end of the training session. Augmented Reality Telementoring may be a time-effective training tool in shortening the pathway to proficiency for laparoscopic novices. Further studies to assess the applicability of ART to remote locations and intra-operative mentoring are underway.
Session: Poster Presentation
Program Number: P140