Comparing Expert and Trainee Levels of Surgical Technical Skills in Virtual Reality Surgical Simulation - A Case Series Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- McGill University
- Enrollment
- 50
- Primary Endpoint
- Simulated bipolar force application
Study Overview
Brief Summary
Background:
The use of virtual reality surgical simulators has been explored as a means of providing objective assessments in surgery. The enormous data generated by simulators can provide an objective and novel insight into the technical composites of expertise.
The objective of this work to form a data repository from expert and trainee levels of surgical performance data using the NeuroVR surgical simulation platform with haptic feedback, which will be used to assess face, content and construct validity of the simulated surgical tasks and develop intelligent systems in future studies.
Specific Aims: 1) Construct a data repository including expert and trainee levels of surgical performance data on virtual reality simulation. 2) Outline the face and content validity of the simulated tasks.
Design: 50 participants from a single university were recruited in this consecutive retrospective case series study.
Setting: Neurosurgical Simulation and Artificial Intelligence Learning Centre, McGill University Participants: Neurosurgeons (14), neurosurgical fellows and neurosurgical residents (24) from Montreal Neurological Institute and Hospital along with medical studies (12).
Task: Complete removal of a simulated tumor with minimal bleeding and damage to surrounding healthy brain using two surgical instruments of the NeuroVR (CAE Healthcare) surgical simulator.
Intervention: A single 28-minute simulation session, including 5 practice scenarios (3 minutes per task) and one complex realistic scenario (13 minutes). Pre- and post-questionnaires to obtain participant demographics and assess face and content validity of the simulated tasks.
Main Outcomes and Measures:
Primary outcome are surgical performance metrics recorded during the simulated tasks including.
- Simulated bipolar and simulated ultrasonic aspirator separation distance Mean instrument tip separation distance in mm
- Simulated bipolar force application Mean bipolar force application in Newtons
- Simulated ultrasonic aspirator force application Mean ultrasonic aspirator force application in Newtons
Secondary outcomes include:
1.Rating of face validity of simulation
Questionnaire using 5 point Likert scale will assess face validity
2 Rating of content validity of simulation
Questionnaire using 5 point Likert scale will assess content validity
.
Detailed Description
Detailed Description:
Background Technological means are being increasingly used in education; however surgical technical skills training is still heavily dependent on expert-trainee relationship. This apprenticeship model faces limitations with the availability of expert surgeons, patient-safety concerns, lack of objectivity, standardization, and quantitation. Surgical interventions carry substantive risks to patients and high costs to health care systems. Consequently, surgical education transforms into more competency-based frameworks by implementing technological means to increase data collection, enable quantification, and objective analysis. Virtual reality simulators have been developed to provide standardized realistic simulated operative environments with the detailed performance data recorded, enabling to explore the composites of technical expertise, and offering new methodologies for surgical training.
Rationale A technically challenging operation in neurosurgery involves the subpial resection of brain tumors adjacent to critical structures. Two simulated tumor resection tasks were developed previously to simulate this procedure using the NeuroVR platform with haptic feedback. The face, content and construct validity of these simulations and methodologies to assess surgical performance in these tasks qualitatively and quantitatively are yet to be explored.
Research Objectives To form a data repository of simulated surgical performance across different expertise levels to allow future studies and to explore face, content and construct validity to develop expert benchmarks and intelligent systems to provide feedback to learners.
Participants do not know about the performance metrics recorded, only that they will be practicing technical skills used in neurosurgery for subpial tumor resection procedures.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Basic Science
- Masking
- None
Masking Description
All participants are provided a number and only the principal investigator has access to this information
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Neurosurgeons
- •Neurosurgical fellows
- •Neurosurgical residents
- •Medical students
Exclusion Criteria
- •Experience with previous similar brain tumor simulation
Arms & Interventions
Neurosurgeons, fellows, residents and medical students
Neurosurgeons (14), neurosurgical fellows and neurosurgical residents (24) from Montreal Neurological Institute and Hospital along with medical students (12) who are enrolled in first to fourth year of McGill medical school.
Intervention: Virtual reality brain tumor simulation (Behavioral)
Outcomes
Primary Outcomes
Simulated bipolar force application
Time Frame: 1 day
Measured in Newtons (range 0-1.5N) values \> 0.5 N poor performance
Simulated ultrasonic aspirator force application
Time Frame: 1 day
Measured in Newtons (range 0-1.5N) values \> 0.5 N poor performance
Simulated bipolar and simulated ultrasonic aspirator separation distance
Time Frame: 1 day
Measured in millimeters (range 0-30mm) values \> 5mm poor performance
Secondary Outcomes
No secondary outcomes reported