Carlos A Lopez, PhD1, Asish Misra, MD2, Nicholas B Milef, BS1, Nicole Santos3, Akole Lamien4, Caroline G.L. Cao, PhD4, Steven Schwaitzberg, MD5, Daniel B Jones, MD2, Suvranu De, ScD1, Jaisa S Olasky, MD6. 1Rensselaer Polytechnic Institute, 2Beth Israel Deaconess Medical Center, 3Cambridge Health Alliance, 4Wright State University, 5University at Buffalo School of Medicine and Biomedical Sciences, 6Department of Surgery, Mount Auburn Hospital
INTRODUCTION: The Virtual Electrosurgical Skill Trainer (VEST) provides surgeons and trainees with a hands-on approach to learning the best practices in electrosurgery. It is comprised of five modules covering tissue effects, stray currents, bipolar tools, monopolar tools and OR fire safety. The module in this study teaches the origins of stray currents and shows the learner how they can cause damage to non-target tissues via direct and capacitive coupling. The aim of this study was to assess learning using the VEST system.
METHODS: The IRB approved study followed a single group pretest-posttest design and was conducted at the SAGES 2017 Learning Center. Thirty-eight subjects participated and out of these, 42% were attending surgeons while the rest were medical students, residents and fellows. 37% of subjects had prior FUSE exposure, while the remaining had none. Subjects were asked to complete a five-question multiple choice questionnaire before and after using the simulator. It assessed their knowledge in topics such as direct coupling, capacitive coupling and insulation failure. Participants then used the simulator to complete three tasks. First, the subject used direct coupling to seal a vessel and observed the desired effects and potential pitfalls. In the second task the subject was immersed inside the peritoneal cavity and was directed to use the active electrode to observe how the activation of energy can cause capacitive coupling. In the third task the subject practiced evaluating the insulation of electrosurgical tools for defects. Wilcoxon’s Signed rank test was used to differentiate between pre- and post-test scores, and the Mann-Whitney U test was used to differentiate between the groups of subjects as a function of FUSE experience.
RESULTS: The median score on the pre-simulator assessment was 60% and the post-simulator median score was 80% (p = 0.035). There was no statistically significant difference in pre-assessment scores between attending surgeons and the others (p = 0.148). Subjects with prior FUSE exposure scored significantly higher on the pre-module assessment compared to those that had no prior FUSE exposure (80% vs 40%, p=0.024). In the post-assessment their median scores were 80% and 60%, respectively (p = 0.019).
CONCLUSIONS: The VEST simulator module successfully increased the overall participants’ knowledge of coupling in electrosurgery regardless of level of surgical experience. Participants with prior exposure to the FUSE curriculum had increased knowledge on this topic at baseline as compared to participants without any FUSE exposure.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87525
Program Number: P330
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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