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Presentation of automated procedural guidance in surgical simulation: results of two randomised controlled trials

Published online by Cambridge University Press:  24 January 2018

S Wijewickrema*
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Australia
Y Zhou
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Australia
I Ioannou
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Australia
B Copson
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Australia
P Piromchai
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Australia Department of Otorhinolaryngology, Khon Kaen University, Thailand
C Yu
Affiliation:
Department of Otolaryngology, Nanjing University, China
R Briggs
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Australia
J Bailey
Affiliation:
Department of Computing and Information Systems, University of Melbourne, Australia
G Kennedy
Affiliation:
Melbourne Centre for the Study of Higher Education, University of Melbourne, Australia
S O'Leary
Affiliation:
Department of Surgery (Otolaryngology), University of Melbourne, Australia
*
Address for correspondence: Dr Sudanthi Wijewickrema, Department of Surgery (Otolaryngology), University of Melbourne, Level 5, Royal Victorian Eye and Ear Hospital, 32, Gisborne Street, East Melbourne, VIC 3002, Australia Fax: +61 3 9663 1958 E-mail: swijewickrem@unimelb.edu.au

Abstract

Objective:

To investigate the effectiveness and usability of automated procedural guidance during virtual temporal bone surgery.

Methods:

Two randomised controlled trials were performed to evaluate the effectiveness, for medical students, of two presentation modalities of automated real-time procedural guidance in virtual reality simulation: full and step-by-step visual presentation of drillable areas. Presentation modality effectiveness was determined through a comparison of participants’ dissection quality, evaluated by a blinded otologist, using a validated assessment scale.

Results:

While the provision of automated guidance on procedure improved performance (full presentation, p = 0.03; step-by-step presentation, p < 0.001), usage of the two different presentation modalities was vastly different (full presentation, 3.73 per cent; step-by-step presentation, 60.40 per cent).

Conclusion:

Automated procedural guidance in virtual temporal bone surgery is effective in improving trainee performance. Step-by-step presentation of procedural guidance was engaging, and therefore more likely to be used by the participants.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2018 

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Footnotes

Presented at the 14th Australasian Auditory Neuroscience Workshop, 4 December 2016, Hobart, Australia.

References

1 Hammoud, MM, Nuthalapaty, FS, Goepfert, AR, Casey, PM, Emmons, S, Espey, EL et al. To the point: medical education review of the role of simulators in surgical training. Am J Obstet Gynecol 2008;199:338–43Google Scholar
2 Reznick, RK, MacRae, H. Teaching surgical skills--changes in the wind. Med Educ 2006;355:2664–9Google Scholar
3 Rhienmora, P, Haddawy, P, Suebnukarn, S, Dailey, MN. Intelligent dental training simulator with objective skill assessment and feedback. Artif Intell Med 2011;52:115–21Google Scholar
4 Fried, MP, Satava, R, Weghorst, S, Gallagher, AG, Sasaki, C, Ross, D et al. Identifying and reducing errors with surgical simulation. Qual Saf Health Care 2004;13(suppl 1):i1926 Google Scholar
5 Zhou, Y, Bailey, J, Ioannou, I, Wijewickrema, S, Kennedy, G, O'Leary, S. Constructive real time feedback for a temporal bone simulator. Med Image Comput Comput Assist Interv 2013;16(Pt 3):315–22Google ScholarPubMed
6 Zhou, Y, Bailey, J, Ioannou, I, Wijewickrema, SN, O'Leary, S, Kennedy, G. Pattern-based real-time feedback for a temporal bone simulator. In: Proceedings of the 19th ACM Symposium on Virtual Reality Software and Technology. New York: ACM, 2013;716 Google Scholar
7 Wijewickrema, S, Piromchai, P, Zhou, Y, Ioannou, I, Bailey, J, Kennedy, G et al. Developing effective automated feedback in temporal bone surgery simulation. Otolaryngol Head Neck Surg 2015;152:1082–8Google Scholar
8 Hatala, R, Cook, DA, Zendejas, B, Hamstra, SJ, Brydges, R. Feedback for simulation-based procedural skills training: a meta-analysis and critical narrative synthesis. Adv Health Sci Educ Theory Pract 2014;19:251–72Google Scholar
9 Stefanidis, D, Korndorffer, JR, Heniford, BT, Scott, DJ. Limited feedback and video tutorials optimize learning and resource utilization during laparoscopic simulator training. Surgery 2007;142:202–6Google Scholar
10 Scott, DJ, Goova, MT, Tesfay, ST. A cost-effective proficiency-based knot-tying and suturing curriculum for residency programs. J Surg Res 2007;141:715 Google Scholar
11 Lamata, P, Enrique, J, Bello, F, Kneebone, RL, Aggarwal, R. Conceptual framework for laparoscopic VR simulators. IEEE Comput Graph Appl 2006;26:6979 Google Scholar
12 Crossan, A, Brewster, S, Reid, S, Mellor, D. Multimodal feedback cues to aid veterinary training simulations. In: Proceedings of the First Workshop on Haptic Human-Computer Interaction. London: Academic Press, 2000;45–9Google Scholar
13 Passmore, PJ, Nielsen, CF, Cosh, W, Darzi, A. Effects of viewing and orientation on path following in a medical teleoperation environment. Proceedings IEEE Virtual Reality 2001;209–15Google Scholar
14 Botden, SM, de Hingh, IH, Jakimowicz, JJ. Meaningful assessment method for laparoscopic suturing training in augmented reality. Surg Endosc 2009;23:2221–8Google Scholar
15 Butler, NN, Wiet, GJ. Reliability of the Welling scale (WS1) for rating temporal bone dissection performance. Laryngoscope 2007;117:1803–8CrossRefGoogle ScholarPubMed
16 McDougall, EM. Validation of surgical simulators. J Endourol 2007;21:244–7Google Scholar
17 Strandbygaard, J, Bjerrum, F, Maagaard, M, Winkel, P, Larsen, CR, Ringsted, C et al. Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized trial. Ann Surg 2013;257:839–44CrossRefGoogle Scholar
18 Kruglikova, I, Grantcharov, TP, Drewes, AM, Funch-Jensen, P. The impact of constructive feedback on training in gastrointestinal endoscopy using high-fidelity virtual-reality simulation: a randomised controlled trial. Gut 2010;59:181–5CrossRefGoogle ScholarPubMed
19 Xeroulis, GJ, Park, J, Moulton, CA, Reznick, RK, LeBlanc, V, Dubrowski, A. Teaching suturing and knot-tying skills to medical students: a randomized controlled study comparing computer-based video instruction and (concurrent and summary) expert feedback. Surgery 2007;141:442–9Google Scholar
20 Walsh, CM, Ling, SC, Wang, CS, Carnahan, H. Concurrent versus terminal feedback: it may be better to wait. Acad Med 2009;84(10 suppl):S54–7Google Scholar
21 Chang, JY, Chang, GL, Chien, CJ, Chung, KC, Hsu, AT. Effectiveness of two forms of feedback on training of a joint mobilization skill by using a joint translation simulator. Phys Ther 2007;87:418–30Google Scholar
22 Wulf, G, Shea, CH. Understanding the role of augmented feedback: the good, the bad and the ugly. In: Williams, AM, Hodges, NJ, eds. Skill Acquisition in Sport: Research, Theory and Practice. London: Routledge, 2004;121–44Google Scholar
23 Salmoni, AW, Schmidt, RA, Walter, CB. Knowledge of results and motor learning: a review and critical reappraisal. Psychol Bull 1984;95:355–86Google Scholar
24 Sweller, J. Cognitive load during problem solving: effects on learning. Cogn Sci 1988;12:257–85CrossRefGoogle Scholar
25 Kirschner, PA. Cognitive load theory: implications of cognitive load theory on the design of learning. Learn Instr 2002;12:110 Google Scholar
26 Ericsson, KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 2004;79:S7081 CrossRefGoogle Scholar
27 Cox, M, Irby, DM, Reznick, RK, MacRae, H. Teaching surgical skills – changes in the wind. N Engl J Med 2006;355:2664–9Google Scholar
28 Wijewickrema, S, Zhou, Y, Bailey, J, Kennedy, G, O'Leary, S. Provision of automated step-by-step procedural guidance in virtual reality surgery simulation. In: Proceedings of the 22nd ACM Conference on Virtual Reality Software and Technology. New York: ACM, 2016;69–72Google Scholar