Single-session baseline virtual reality simulator scores predict technical performance for laparoscopic colectomy: a study in the swine model.
OBJECTIVE
Virtual reality (VR) simulation helps reducing the learning curve of laparoscopic colectomy. Moreover, it may be used to ascertain surgeons' pretraining skills. It was aimed to establish predictive validity of specific parameters gathered during VR simulation training on sigmoid colectomy and whether simulator parameters correlate with technical performance during the same operation in a swine model.


DESIGN
Surgeons novice to laparoscopic colectomy underwent a single VR simulation session on sigmoid colectomy. Next, all participants performed a laparoscopic sigmoidectomy in the swine. Operations were recorded. Performance evaluation was conducted by 2 board-certified colorectal surgeons blinded to surgeons' simulator scores using an instrument specific to laparoscopic colectomy. For each participant, a mean score of specific skills was calculated. Linear regression analysis was used to identify simulator parameters that were best related to the score. The stepwise method was used to select parameters. The magnitude of the regression model was measured by the coefficient of determination (R(2)) value.


SETTING
The University of Sao Paulo Medical Center is a high-volume, public practice, university-affiliated hospital.


PARTICIPANTS
A total of 14 first-year residents in digestive tract surgery were included.


RESULTS
Analysis of variance demonstrated that the regression model was significant (p = 0.0001), and an association between simulation scores and specific skills was confirmed. The R(2) value was 99%. The VR simulator parameters that strongly correlated with specific skills during laparoscopic colectomy in the swine were safe use of electrosurgery/energy device and safety of medial-to-lateral dissection.


CONCLUSIONS
A single VR simulation session for novice surgeons in the sigmoid colectomy module generates baseline scores that highly correlated with performance of specific skills during a laparoscopic colectomy in the swine. This information may be useful in an attempt to tailor VR simulator practice according to a surgeon's needs.
['Araujo|Sergio Eduardo Alonso|SE|', 'Seid|Victor E|VE|', 'Bertoncini|Alexandre B|AB|', 'Horcel|Lucas A|LA|', 'Nahas|Sergio C|SC|', 'Cecconello|Ivan|I|']
D000818:Animals D002983:Clinical Competence D003082:Colectomy D003194:Computer-Assisted Instruction D004503:Education, Medical, Graduate D004521:Educational Measurement D006801:Humans D007396:Internship and Residency D010535:Laparoscopy D023421:Models, Animal D013552:Swine D014584:User-Computer Interface
colectomy Medical Knowledge Patient Care Practice-Based Learning and Improvement clinical skills colonic neoplasms credentialing education laparoscopy