Virtual reality training improves operating room performance results of a randomized, double-blinded study

Neal E. Seymour, Anthony G. Gallagher, Sanziana A. Roman, Michael K. O'Brien, Vipin K. Bansal, Dana Andersen, Richard M. Satava, Carlos A. Pellegrini, Ajit K. Sachdeva, Johnathan L. Meakins, Leslie H. Blumgart

Research output: Contribution to journalArticle

1734 Citations (Scopus)

Abstract

Objective: To demonstrate that virtual reality (VR) training transfers technical skills to the operating room (OR) environment. Summary Background Data: The use of VR surgical simulation to train skills and reduce error risk in the OR has never been demonstrated in a prospective, randomized, blinded study. Methods: Sixteen surgical residents (PGY 1-4) had baseline psychomotor abilities assessed, then were randomized to either VR training (MIST VR simulator diathermy task) until expert criterion levels established by experienced laparoscopists were achieved (n = 8), or control non-VR-trained (n = 8). All subjects performed laparoscopic cholecystectomy with an attending surgeon blinded to training status, Videotapes of gallbladder dissection were reviewed independently by two investigators blinded to subject identity and training, and scored for eight predefined errors for each procedure minute (interrater reliability of error assessment r > 0.80). Results: No differences in baseline assessments were found between groups. Gallbladder dissection was 29% faster for VR-trained residents. Non-VR-trained residents were nine times more likely to transiently fail to make progress (P <.007, Mann-Whitney test) and five times more likely to injure the gallbladder or burn nontarget tissue (chi-square = 4.27, P <.04). Mean errors were six times less likely to occur in the VR-trained group (1.19 vs. 7.38 errors per case; P <.008, Mann-Whitney test). Conclusions The use of VR surgical simulation to reach specific target criteria significantly improved the OR performance of residents during laparoscopic cholecystectomy. This validation of transfer of training skills from VR to OR sets the stage for more sophisticated uses of VR in assessment, training, error reduction, and certification of surgeons.

Original languageEnglish (US)
Pages (from-to)458-464
Number of pages7
JournalAnnals of Surgery
Volume236
Issue number4
DOIs
StatePublished - Oct 2002
Externally publishedYes

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Operating Rooms
Gallbladder
Laparoscopic Cholecystectomy
Dissection
Diathermy
Videotape Recording
Aptitude
Certification
Research Personnel
Surgeons
Transfer (Psychology)

ASJC Scopus subject areas

  • Surgery

Cite this

Seymour, N. E., Gallagher, A. G., Roman, S. A., O'Brien, M. K., Bansal, V. K., Andersen, D., ... Blumgart, L. H. (2002). Virtual reality training improves operating room performance results of a randomized, double-blinded study. Annals of Surgery, 236(4), 458-464. https://doi.org/10.1097/00000658-200210000-00008

Virtual reality training improves operating room performance results of a randomized, double-blinded study. / Seymour, Neal E.; Gallagher, Anthony G.; Roman, Sanziana A.; O'Brien, Michael K.; Bansal, Vipin K.; Andersen, Dana; Satava, Richard M.; Pellegrini, Carlos A.; Sachdeva, Ajit K.; Meakins, Johnathan L.; Blumgart, Leslie H.

In: Annals of Surgery, Vol. 236, No. 4, 10.2002, p. 458-464.

Research output: Contribution to journalArticle

Seymour, NE, Gallagher, AG, Roman, SA, O'Brien, MK, Bansal, VK, Andersen, D, Satava, RM, Pellegrini, CA, Sachdeva, AK, Meakins, JL & Blumgart, LH 2002, 'Virtual reality training improves operating room performance results of a randomized, double-blinded study', Annals of Surgery, vol. 236, no. 4, pp. 458-464. https://doi.org/10.1097/00000658-200210000-00008
Seymour, Neal E. ; Gallagher, Anthony G. ; Roman, Sanziana A. ; O'Brien, Michael K. ; Bansal, Vipin K. ; Andersen, Dana ; Satava, Richard M. ; Pellegrini, Carlos A. ; Sachdeva, Ajit K. ; Meakins, Johnathan L. ; Blumgart, Leslie H. / Virtual reality training improves operating room performance results of a randomized, double-blinded study. In: Annals of Surgery. 2002 ; Vol. 236, No. 4. pp. 458-464.
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abstract = "Objective: To demonstrate that virtual reality (VR) training transfers technical skills to the operating room (OR) environment. Summary Background Data: The use of VR surgical simulation to train skills and reduce error risk in the OR has never been demonstrated in a prospective, randomized, blinded study. Methods: Sixteen surgical residents (PGY 1-4) had baseline psychomotor abilities assessed, then were randomized to either VR training (MIST VR simulator diathermy task) until expert criterion levels established by experienced laparoscopists were achieved (n = 8), or control non-VR-trained (n = 8). All subjects performed laparoscopic cholecystectomy with an attending surgeon blinded to training status, Videotapes of gallbladder dissection were reviewed independently by two investigators blinded to subject identity and training, and scored for eight predefined errors for each procedure minute (interrater reliability of error assessment r > 0.80). Results: No differences in baseline assessments were found between groups. Gallbladder dissection was 29{\%} faster for VR-trained residents. Non-VR-trained residents were nine times more likely to transiently fail to make progress (P <.007, Mann-Whitney test) and five times more likely to injure the gallbladder or burn nontarget tissue (chi-square = 4.27, P <.04). Mean errors were six times less likely to occur in the VR-trained group (1.19 vs. 7.38 errors per case; P <.008, Mann-Whitney test). Conclusions The use of VR surgical simulation to reach specific target criteria significantly improved the OR performance of residents during laparoscopic cholecystectomy. This validation of transfer of training skills from VR to OR sets the stage for more sophisticated uses of VR in assessment, training, error reduction, and certification of surgeons.",
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AU - Gallagher, Anthony G.

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AU - Bansal, Vipin K.

AU - Andersen, Dana

AU - Satava, Richard M.

AU - Pellegrini, Carlos A.

AU - Sachdeva, Ajit K.

AU - Meakins, Johnathan L.

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N2 - Objective: To demonstrate that virtual reality (VR) training transfers technical skills to the operating room (OR) environment. Summary Background Data: The use of VR surgical simulation to train skills and reduce error risk in the OR has never been demonstrated in a prospective, randomized, blinded study. Methods: Sixteen surgical residents (PGY 1-4) had baseline psychomotor abilities assessed, then were randomized to either VR training (MIST VR simulator diathermy task) until expert criterion levels established by experienced laparoscopists were achieved (n = 8), or control non-VR-trained (n = 8). All subjects performed laparoscopic cholecystectomy with an attending surgeon blinded to training status, Videotapes of gallbladder dissection were reviewed independently by two investigators blinded to subject identity and training, and scored for eight predefined errors for each procedure minute (interrater reliability of error assessment r > 0.80). Results: No differences in baseline assessments were found between groups. Gallbladder dissection was 29% faster for VR-trained residents. Non-VR-trained residents were nine times more likely to transiently fail to make progress (P <.007, Mann-Whitney test) and five times more likely to injure the gallbladder or burn nontarget tissue (chi-square = 4.27, P <.04). Mean errors were six times less likely to occur in the VR-trained group (1.19 vs. 7.38 errors per case; P <.008, Mann-Whitney test). Conclusions The use of VR surgical simulation to reach specific target criteria significantly improved the OR performance of residents during laparoscopic cholecystectomy. This validation of transfer of training skills from VR to OR sets the stage for more sophisticated uses of VR in assessment, training, error reduction, and certification of surgeons.

AB - Objective: To demonstrate that virtual reality (VR) training transfers technical skills to the operating room (OR) environment. Summary Background Data: The use of VR surgical simulation to train skills and reduce error risk in the OR has never been demonstrated in a prospective, randomized, blinded study. Methods: Sixteen surgical residents (PGY 1-4) had baseline psychomotor abilities assessed, then were randomized to either VR training (MIST VR simulator diathermy task) until expert criterion levels established by experienced laparoscopists were achieved (n = 8), or control non-VR-trained (n = 8). All subjects performed laparoscopic cholecystectomy with an attending surgeon blinded to training status, Videotapes of gallbladder dissection were reviewed independently by two investigators blinded to subject identity and training, and scored for eight predefined errors for each procedure minute (interrater reliability of error assessment r > 0.80). Results: No differences in baseline assessments were found between groups. Gallbladder dissection was 29% faster for VR-trained residents. Non-VR-trained residents were nine times more likely to transiently fail to make progress (P <.007, Mann-Whitney test) and five times more likely to injure the gallbladder or burn nontarget tissue (chi-square = 4.27, P <.04). Mean errors were six times less likely to occur in the VR-trained group (1.19 vs. 7.38 errors per case; P <.008, Mann-Whitney test). Conclusions The use of VR surgical simulation to reach specific target criteria significantly improved the OR performance of residents during laparoscopic cholecystectomy. This validation of transfer of training skills from VR to OR sets the stage for more sophisticated uses of VR in assessment, training, error reduction, and certification of surgeons.

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