ABSTRACT
Objective To investigate the performance of laparoscopic camera navigation training for medical students using the virtual reality simulator .Methods Ten medical clerks ( group A ) , 10 medical interns ( group B ) and 10 first year surgical residents (group C) are randomly enrolled in this study , and 10 surgical attendings (group D) are enrolled as control group .The performance of pre-training and post-training is analyzed .Results The performance of pre-training and post-training in the same group was significant improved ( P<0.05) and there was significant differ-ence among group A , B and C, also there was significant difference between the training group and the surgical at -tendings (control group) (P<0.05), respectively.Conclusions The laparoscopic camera navigation skills can be improved by laparoscopic virtual reality simulator especially for the medical interns and surgical residents .
ABSTRACT
Objective To investigate the potential effectiveness of a computer-based gastrointestinal (GI) endoscopy simulator in assessing the competence of GI endoscopy trainees.Methods Fifty trainees working in the endoscopy center of General Hospital of Chinese PLA between February 2009 and October 2011 were enrolled.These participants were divided into four groups based on their prior endoscopic experience:novices (no endoscopy experience),intermediate experienced (≤200 colonoscopies or ≤ 500 gastroscopies),experienced (201-1000 colonoscopies or 501-2000 gastroscopies),and experts (＞ 1000 colonoscopies or ＞ 2000 gastroscopies).Assessment of endoscopic skills was performed during a hand-eye coordination task (Endo Bubble level 1) and was based on parameters measured by the computer system including time to finish,average time between two bubbles,number of times wall touched.Results When GI trainees were categorized by their prior gastroscopy number,the time to finish of each group were (302.43 ± 108.96)s,(188.00 ± 59.88) s,135.00 (40.00) s,150.00 (69.00) s,and the average time between two bubbles were (14.29 ± 5.47) s,(8.82 ± 3.28) s,6.00 (2.00) s,7.00 (4.00) s,respectively.Pairwise comparison showed that except experienced and experts groups (P ＞ 0.05),there were significantly differences between remaining groups (P ＜0.01).However,based on the colonoscopic experiences,the time to finish of each group were 220.00(91.00)s,127.00(28.25)s,155.50(81.00)s,150.00(58.50)s,respectively,which were significantly different between each two groups (P ＜ 0.01).Average time between two bubbles of each group were 10.00 (4.00) s,5.50 (1.50) s,7.00 (3.75) s,7.00 (3.50) s,respectively,which were found significantly different among whole groups (P ＜ 0.05 or P ＜ 0.01),but there were no differences between novice and experienced trainees and between intermediate experienced and experts groups.In contrast,the number of wall-touch was insufficient for assessment.Except the significant difference between novice and experienced group (P ＜ 0.05) as categorized by gastroscopy experience,there were no values to differentiate the trainees of different practical competence on gastroscopy or colonoscopy.Conclusion The parameter,time to finish,during a hand-eye coordination task using a virtual reality simulator might be able to differentiate the competence of operators,which was used prior to training in real-life endoscopy,but lack of accurate discriminatory function between experienced and experts.