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Abjigitova D, Sadeghi AH, Peek JJ, Bekkers JA, Bogers AJJC, Mahtab EAF. Virtual Reality in the Preoperative Planning of Adult Aortic Surgery: A Feasibility Study. J Cardiovasc Dev Dis 2022; 9:jcdd9020031. [PMID: 35200685 PMCID: PMC8879426 DOI: 10.3390/jcdd9020031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Complex aortic anatomy needs careful preoperative planning in which a patient-tailored approach with novel immersive techniques could serve as a valuable addition to current preoperative imaging. This pilot study aimed to investigate the technical feasibility of virtual reality (VR) as an additional imaging tool for preoperative planning in ascending aortic surgery. Methods: Ten cardiothoracic surgeons were presented with six patients who had each undergone a recent repair of the ascending aorta. Two-dimensional computed tomography images of each patient were assessed prior to the VR session. After three-dimensional (3D) VR rendering and 3D segmentation of the ascending aorta and aortic arch, the reconstructions were analyzed by each surgeon in VR via a head-mounted display. Each cardiothoracic surgeon completed a questionnaire after each planning procedure. The results of their assessments were compared to the performed operations. The primary endpoint of the present study was a change of surgical approach from open to clamped distal anastomosis, and vice versa. Results: Compared with conventional imaging, 80% of surgeons found that VR prepared them better for surgery. In 33% of cases (two out of six), the preoperative decision was adjusted due to the 3D VR-based evaluation of the anatomy. Surgeons rated CardioVR usefulness, user-friendliness, and satisfaction with median scores of 3.8 (IQR: 3.5–4.1), 4.2 (IQR: 3.8–4.6,) and 4.1 (IQR: 3.8–4.7) on a five-point Likert scale, respectively. Conclusions: Three-dimensional VR imaging was associated with improved anatomical understanding among surgeons and could be helpful in the future preoperative planning of ascending aortic surgery.
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Wu JH, Du JK, Lee CY. Development and questionnaire-based evaluation of virtual dental clinic: a serious game for training dental students. MEDICAL EDUCATION ONLINE 2021; 26:1983927. [PMID: 34694980 PMCID: PMC8547877 DOI: 10.1080/10872981.2021.1983927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/24/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The volume of literature about serious gaming in dental education has increased, however, none of the previous studies have developed a serious game for closing the gap between preclinical and clinical training. OBJECTIVE Virtual Dental Clinic (VDC) is a serious game that was created to help develop clinical reasoning skills in dental students. This study aimed to evaluate VDC as an educational tool and its effectiveness on clinical skill and knowledge gain among clerkship dental students. METHODS The following three stages of VDC design and testing were addressed from 2016 to 2020: development, validation, and application. The VDC was developed using Unity game engine. In the validation stage, the content validity was reviewed by five visiting staff; construct validity and face validity were examined by 9 postgraduate-year dentists and 14 clerkship dental students. Concurrent validity and predictive validity were examined by 34 fifth-year dental students during their clerkship from September, 2018 to May, 2019, the associations between VDC experiences, clerkship performance, and the score on a national qualification test were explored. In the application stage, the VDC was set up as a self-learning tool in the Family Dentistry Department from August, 2019, quantitative and qualitative analyses were conducted using the 92 clerkship students' feedback. RESULTS The VDC showed good validity and a high potential for education in practice. Students who have used VDC received significantly higher scores on qualification test (p = 0.029); the VDC experiences significantly predicted higher performance score on periodontics (p = 0.037) and endodontics (p = 0.040). After the outbreak of COVID-19 pandemic, significantly higher proportion of students confirmed the value of VDC as an assistant tool for learning clinical reasoning (p = 0.019). CONCLUSIONS The VDC as an educational tool, and the effectiveness on clinical reasoning skills and knowledge gain among clerkship dental students has been validated and confirmed in this study.
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Affiliation(s)
- Ju-Hui Wu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Je-Kang Du
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chen-Yi Lee
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Feeley A, Feeley I, Merghani K, Sheehan E. A pilot study to evaluate the face & construct validity of an orthopaedic virtual reality simulator. Injury 2021; 52:1715-1720. [PMID: 33926708 DOI: 10.1016/j.injury.2021.04.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/10/2021] [Indexed: 02/07/2023]
Abstract
AIMS This study aimed to identify the face and construct validity of the Precision OS trauma module proximal femoral nail procedure. Secondary outcomes included perceived use of simulation in surgical training, with structured feedback from participants. METHODS A comparative interventional study was carried out in a regional orthopaedics trauma unit hospital. Volunteers were stratified into novice, intermediate and expert groups based on self-reported levels of experience. Each participant carried out a simulated proximal femoral nail on an immersive virtual platform following instruction on its use, with objective metrics such as time and x-rays, and novel metrics calculated by the simulation module recorded. Face validity was also assessed. RESULTS The proximal femoral nail module demonstrated construct validity. Kruskal Wallis test demonstrated a statistically significant difference across all group's novel performance (p=.018). Intermediate surgeons performed significantly better than novices (P=.022), with shorter procedural times (P=.018) Three of the intermediate group achieved the proficiency level set by the expert group, with no significant difference noted between these two groups (=.06). Time taken to completion for expert surgeons was less than intermediate group, although this did not reach significance (P=.19). CONCLUSION The proximal femoral nail module on the Precision OS platform demonstrated good face, and construct validity. Further research evaluating use of virtual platform simulation in surgical trauma training is needed.
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Affiliation(s)
- Aoife Feeley
- Midlands Regional Hospital Tullamore, Arden Rd, Puttaghan, Tullamore, Co. Offaly R35 NY51, Ireland.
| | - Iain Feeley
- Midlands Regional Hospital Tullamore, Arden Rd, Puttaghan, Tullamore, Co. Offaly R35 NY51, Ireland
| | - Khalid Merghani
- Midlands Regional Hospital Tullamore, Arden Rd, Puttaghan, Tullamore, Co. Offaly R35 NY51, Ireland
| | - Eoin Sheehan
- Midlands Regional Hospital Tullamore, Arden Rd, Puttaghan, Tullamore, Co. Offaly R35 NY51, Ireland
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Li Y, Ye H, Ye F, Liu Y, Lv L, Zhang P, Zhang X, Zhou Y. The Current Situation and Future Prospects of Simulators in Dental Education. J Med Internet Res 2021; 23:e23635. [PMID: 33830059 PMCID: PMC8063092 DOI: 10.2196/23635] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/26/2020] [Accepted: 01/29/2021] [Indexed: 01/22/2023] Open
Abstract
The application of virtual reality has become increasingly extensive as this technology has developed. In dental education, virtual reality is mainly used to assist or replace traditional methods of teaching clinical skills in preclinical training for several subjects, such as endodontics, prosthodontics, periodontics, implantology, and dental surgery. The application of dental simulators in teaching can make up for the deficiency of traditional teaching methods and reduce the teaching burden, improving convenience for both teachers and students. However, because of the technology limitations of virtual reality and force feedback, dental simulators still have many hardware and software disadvantages that have prevented them from being an alternative to traditional dental simulators as a primary skill training method. In the future, when combined with big data, cloud computing, 5G, and deep learning technology, dental simulators will be able to give students individualized learning assistance, and their functions will be more diverse and suitable for preclinical training. The purpose of this review is to provide an overview of current dental simulators on related technologies, advantages and disadvantages, methods of evaluating effectiveness, and future directions for development.
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Affiliation(s)
- Yaning Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Key Laboratory of Digital Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hongqiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Key Laboratory of Digital Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Fan Ye
- The State Key Laboratory of Virtual Reality Technology and Systems, School of Computer Science and Engineering, Beihang University, Beijing, China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Key Laboratory of Digital Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Longwei Lv
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Key Laboratory of Digital Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ping Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Key Laboratory of Digital Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiao Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Key Laboratory of Digital Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Key Laboratory of Digital Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
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Alvarez-Lopez F, Maina MF, Saigí-Rubió F. Use of a Low-Cost Portable 3D Virtual Reality Gesture-Mediated Simulator for Training and Learning Basic Psychomotor Skills in Minimally Invasive Surgery: Development and Content Validity Study. J Med Internet Res 2020; 22:e17491. [PMID: 32673217 PMCID: PMC7388055 DOI: 10.2196/17491] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/26/2020] [Accepted: 02/29/2020] [Indexed: 02/06/2023] Open
Abstract
Background Simulation in virtual environments has become a new paradigm for surgeon training in minimally invasive surgery (MIS). However, this technology is expensive and difficult to access. Objective This study aims first to describe the development of a new gesture-based simulator for learning skills in MIS and, second, to establish its fidelity to the criterion and sources of content-related validity evidence. Methods For the development of the gesture-mediated simulator for MIS using virtual reality (SIMISGEST-VR), a design-based research (DBR) paradigm was adopted. For the second objective, 30 participants completed a questionnaire, with responses scored on a 5-point Likert scale. A literature review on the validity of the MIS training-VR (MIST-VR) was conducted. The study of fidelity to the criterion was rated using a 10-item questionnaire, while the sources of content-related validity evidence were assessed using 10 questions about the simulator training capacity and 6 questions about MIS tasks, and an iterative process of instrument pilot testing was performed. Results A good enough prototype of a gesture-based simulator was developed with metrics and feedback for learning psychomotor skills in MIS. As per the survey conducted to assess the fidelity to the criterion, all 30 participants felt that most aspects of the simulator were adequately realistic and that it could be used as a tool for teaching basic psychomotor skills in laparoscopic surgery (Likert score: 4.07-4.73). The sources of content-related validity evidence showed that this study’s simulator is a reliable training tool and that the exercises enable learning of the basic psychomotor skills required in MIS (Likert score: 4.28-4.67). Conclusions The development of gesture-based 3D virtual environments for training and learning basic psychomotor skills in MIS opens up a new approach to low-cost, portable simulation that allows ubiquitous learning and preoperative warm-up. Fidelity to the criterion was duly evaluated, which allowed a good enough prototype to be achieved. Content-related validity evidence for SIMISGEST-VR was also obtained.
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Affiliation(s)
| | - Marcelo Fabián Maina
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
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Aussedat C, Robier M, Aoustin JM, Parietti-Winkler C, Lescanne E, Bonnard D, Marx M, Teissier N, Van Den Abbeele T, François M, Galvin J, Bakhos D. Using virtual reality in audiological training: Our experience in 22 otolaryngology residents. Clin Otolaryngol 2020; 45:643-648. [PMID: 32306528 DOI: 10.1111/coa.13554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Charles Aussedat
- Service ORL et Chirurgie Cervico-Faciale, CHU de Tours, Tours, France.,Faculté de Médecine de Tours, CHRU de Tours, Université François-Rabelais de Tours, Tours, France
| | - Mathieu Robier
- Service ORL et Chirurgie Cervico-Faciale, CHU de Tours, Tours, France
| | | | | | - Emmanuel Lescanne
- Service ORL et Chirurgie Cervico-Faciale, CHU de Tours, Tours, France.,Faculté de Médecine de Tours, CHRU de Tours, Université François-Rabelais de Tours, Tours, France
| | - Damien Bonnard
- Department of Otorhinolaryngology and Skull Base Surgery, Pellegrin University Hospital, University of Bordeaux, Bordeaux, France
| | - Mathieu Marx
- Service d'Oto-Rhino-Laryngologie, d'Oto-Neurologie et d'ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Toulouse Cedex 9, France
| | - Natacha Teissier
- Department of Pediatric Otorhinolaryngology, Head & Neck Surgery, Robert Debré University Hospital APHP, Paris 7 University, Sorbonne Cité, Paris, France
| | - Thierry Van Den Abbeele
- Department of Pediatric Otorhinolaryngology, Head & Neck Surgery, Robert Debré University Hospital APHP, Paris 7 University, Sorbonne Cité, Paris, France
| | - Martine François
- Department of Pediatric Otorhinolaryngology, Head & Neck Surgery, Robert Debré University Hospital APHP, Paris 7 University, Sorbonne Cité, Paris, France
| | | | - David Bakhos
- Service ORL et Chirurgie Cervico-Faciale, CHU de Tours, Tours, France.,Faculté de Médecine de Tours, CHRU de Tours, Université François-Rabelais de Tours, Tours, France.,INSERM UMR 1253 I-brain, CHRU de Tours, Université François-Rabelais de Tours, Tours, France
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7
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Mu Y, Hocking D, Wang ZT, Garvin GJ, Eagleson R, Peters TM. Augmented reality simulator for ultrasound-guided percutaneous renal access. Int J Comput Assist Radiol Surg 2020; 15:749-757. [DOI: 10.1007/s11548-020-02142-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/26/2020] [Indexed: 12/27/2022]
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8
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Tang KS, Cheng DL, Mi E, Greenberg PB. Augmented reality in medical education: a systematic review. CANADIAN MEDICAL EDUCATION JOURNAL 2020; 11:e81-e96. [PMID: 32215146 PMCID: PMC7082471 DOI: 10.36834/cmej.61705] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
INTRODUCTION The field of augmented reality (AR) is rapidly growing with many new potential applications in medical education. This systematic review investigated the current state of augmented reality applications (ARAs) and developed an analytical model to guide future research in assessing ARAs as teaching tools in medical education. METHODS A literature search was conducted using PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar. This review followed PRISMA guidelines and included publications from January 1, 2000 to June 18, 2018. Inclusion criteria were experimental studies evaluating ARAs implemented in healthcare education published in English. Our review evaluated study quality and determined whether studies assessed ARA validity using criteria established by the GRADE Working Group and Gallagher et al., respectively. These findings were used to formulate an analytical model to assess the readiness of ARAs for implementation in medical education. RESULTS We identified 100,807 articles in the initial literature search; 36 met inclusion criteria for final review and were categorized into three categories: Surgery (23), Anatomy (9), and Other (4). The overall quality of the studies was poor and no ARA was tested for all five stages of validity. Our analytical model evaluates the importance of research quality, application content, outcomes, and feasibility of an ARA to gauge its readiness for implementation. CONCLUSION While AR technology is growing at a rapid rate, the current quality and breadth of AR research in medical training is insufficient to recommend the adoption into educational curricula. We hope our analytical model will help standardize AR assessment methods and define the role of AR technology in medical education.
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Affiliation(s)
- Kevin S. Tang
- The Program in Liberal Medical Education of Brown University, Rhode Island, USA
- The Warren Alpert Medical School of Brown University, Rhode Island, USA
- Division of Ophthalmology, Warren Alpert Medical School, Rhode Island, USA
- Section of Ophthalmology, Providence VA Medical Center, Rhode Island, USA
| | - Derrick L. Cheng
- The Program in Liberal Medical Education of Brown University, Rhode Island, USA
- The Warren Alpert Medical School of Brown University, Rhode Island, USA
- Lifespan Clinical Research Center, Rhode Island, USA
| | - Eric Mi
- The Program in Liberal Medical Education of Brown University, Rhode Island, USA
| | - Paul B. Greenberg
- Division of Ophthalmology, Warren Alpert Medical School, Rhode Island, USA
- Section of Ophthalmology, Providence VA Medical Center, Rhode Island, USA
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Lu C, Ghoman SK, Cutumisu M, Schmölzer GM. Unsupervised Machine Learning Algorithms Examine Healthcare Providers' Perceptions and Longitudinal Performance in a Digital Neonatal Resuscitation Simulator. Front Pediatr 2020; 8:544. [PMID: 33042905 PMCID: PMC7518390 DOI: 10.3389/fped.2020.00544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/29/2020] [Indexed: 12/05/2022] Open
Abstract
Background: Frequent simulation-based education is recommended to improve health outcomes during neonatal resuscitation but is often inaccessible due to time, resource, and personnel requirements. Digital simulation presents a potential alternative; however, its effectiveness and reception by healthcare professionals (HCPs) remains largely unexplored. Objectives: This study explores HCPs' attitudes toward a digital simulator, technology, and mindset to elucidate their effects on neonatal resuscitation performance in simulation-based assessments. Methods: The study was conducted from April to August 2019 with 2-month (June-October 2019) and 5-month (September 2019-January 2020) follow-up at a tertiary perinatal center in Edmonton, Canada. Of 300 available neonatal HCPs, 50 participated. Participants completed a demographic survey, a pretest, two practice scenarios using the RETAIN neonatal resuscitation digital simulation, a posttest, and an attitudinal survey (100% response rate). Participants repeated the posttest scenario in 2 months (86% response rate) and completed another posttest scenario using a low-fidelity, tabletop simulator (80% response rate) 5 months after the initial study intervention. Participants' survey responses were collected to measure attitudes toward digital simulation and technology. Knowledge was assessed at baseline (pretest), acquisition (posttest), retention (2-month posttest), and transfer (5-month posttest). Results: Fifty neonatal HCPs participated in this study (44 females and 6 males; 27 nurses, 3 nurse practitioners, 14 respiratory therapists, and 6 doctors). Most participants reported technology in medical education as useful and beneficial. Three attitudinal clusters were identified by a hierarchical clustering algorithm based on survey responses. Although participants exhibited diverse attitudinal paths, they all improved neonatal resuscitation performance after using the digital simulator and successfully transferred their knowledge to a new medium. Conclusions: Digital simulation improved HCPs' neonatal resuscitation performance. Medical education may benefit by incorporating technology during simulation training.
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Affiliation(s)
- Chang Lu
- Department of Educational Psychology, Faculty of Education, Centre for Research in Applied Measurement and Evaluation, University of Alberta, Edmonton, AB, Canada
| | - Simran K Ghoman
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Maria Cutumisu
- Department of Educational Psychology, Faculty of Education, Centre for Research in Applied Measurement and Evaluation, University of Alberta, Edmonton, AB, Canada.,Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.,Department of Computing Science, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Georg M Schmölzer
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Meijer HA, Graafland M, Obdeijn MC, Goslings JC, Schijven MP. Face Validity and Content Validity of a Game for Distal Radius Fracture Rehabilitation. J Wrist Surg 2019; 8:388-394. [PMID: 31579548 PMCID: PMC6773587 DOI: 10.1055/s-0039-1688948] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
Background Patients recovering from a variety of wrist injuries are frequently advised to exercise to regain lost wrist and hand function. Treatment regimens to regain motion in the wrist are highly variable, and adherence to exercise protocols is known to be low. A serious game ReValidate! incorporating standardized exercise regimens was developed to motivate patients. In this study, the game is evaluated regarding its face validity and content validity. Methods In this cross-sectional study, a mixed group of "users" ( n = 53) including patients currently recovering from wrist injury, and a mixed group of "experts" ( n = 46) including professionals advising patients on therapy regimen after wrist injury played at least one complete level of the serious game. Players evaluated the game by means of a structured questionnaire regarding its content, clinical applicability, and user experience. Questions were answered on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Results All groups valued the game as being able to support wrist rehabilitation and being of use to patients recovering from a distal radius fracture (users: median 4, P25-P75 3-4 vs. experts: median 4, P25-P75 3.50-5; p = not significant). The types of exercises performed during the game were considered to be both realistic and complete compared with regular physiotherapy exercises (users: median 4, P25-P75 3-4 vs. experts: median 4, P25-P75 3-5, p = not significant). Conclusions The ReValidate! serious game can be regarded as a valid tool for patients to regain their wrist function after injury. Level of evidence This is a Level II study.
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Affiliation(s)
- Henriëtte A.W. Meijer
- Department of Surgery, Academic Medical Center, Amsterdam UMC, AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Maurits Graafland
- Department of Surgery, Amsterdam UMC, AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Miryam C. Obdeijn
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - J. Carel Goslings
- Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Marlies P. Schijven
- Department of Surgery, Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam UMC, AMC, University of Amsterdam, Amsterdam, the Netherlands
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11
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Towards Virtual VATS, Face, and Construct Evaluation for Peg Transfer Training of Box, VR, AR, and MR Trainer. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:6813719. [PMID: 30723539 PMCID: PMC6339710 DOI: 10.1155/2019/6813719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/31/2018] [Accepted: 11/29/2018] [Indexed: 11/17/2022]
Abstract
The aim of this study is to develop and assess the peg transfer training module face, content and construct validation use of the box, virtual reality (VR), cognitive virtual reality (CVR), augmented reality (AR), and mixed reality (MR) trainer, thereby to compare advantages and disadvantages of these simulators. Training system (VatsSim-XR) design includes customized haptic-enabled thoracoscopic instruments, virtual reality helmet set, endoscope kit with navigation, and the patient-specific corresponding training environment. A cohort of 32 trainees comprising 24 novices and 8 experts underwent the real and virtual simulators that were conducted in the department of thoracic surgery of Yunnan First People's Hospital. Both subjective and objective evaluations have been developed to explore the visual and haptic potential promotions in peg transfer education. Experiments and evaluation results conducted by both professional and novice thoracic surgeons show that the surgery skills from experts are better than novices overall, AR trainer is able to provide a more balanced training environments on visuohaptic fidelity and accuracy, box trainer and MR trainer demonstrated the best realism 3D perception and surgical immersive performance, respectively, and CVR trainer shows a better clinic effect that the traditional VR trainer. Combining these in a systematic approach, tuned with specific fidelity requirements, medical simulation systems would be able to provide a more immersive and effective training environment.
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12
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Johnsen HM, Fossum M, Vivekananda-Schmidt P, Fruhling A, Slettebø Å. Nursing students' perceptions of a video-based serious game's educational value: A pilot study. NURSE EDUCATION TODAY 2018; 62:62-68. [PMID: 29306100 DOI: 10.1016/j.nedt.2017.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 11/19/2017] [Accepted: 12/18/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Despite an increasing number of serious games (SGs) in nursing education, few evaluation studies specifically address their educational value in terms of face, content, and construct validity. OBJECTIVES To assess nursing students' perceptions of a video-based SG in terms of face, content, and construct validity. In addition, the study assessed perceptions of usability, individual factors, and preferences regarding future use. DESIGN A pilot study was conducted. SETTING AND PARTICIPANTS An SG prototype was implemented as part of two simulation courses in nursing education: one for home health care and one for hospital medical-surgical wards. The SG aimed to teach clinical reasoning and decision-making skills to nursing students caring for patients with chronic obstructive pulmonary disease. A total of 249second-year nursing students participated in pilot testing of the SG. METHOD A paper-based survey was used to assess students' perceptions of the SG's educational value. RESULTS Overall, students from both simulation courses perceived the SG as educationally valuable and easy to use. No significant differences were found in perceptions of educational value between nursing students with previous healthcare experience versus those with none. However, significantly more students in the home healthcare simulation course indicated that the SG tested their clinical reasoning and decision-making skills. Students from both the medical-surgical and home healthcare simulation courses suggested that more video-based SGs should be developed and used in nursing education. CONCLUSIONS Overall, the survey results indicate that the participants perceived the SG as educationally valuable, and that the SG has potential as an educational tool in nursing education, especially in caring for patients with chronic diseases and in home healthcare simulation. Showing a SG's educational value and user acceptance among nursing students may justify the development and application of more SGs in nursing education.
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Affiliation(s)
- Hege M Johnsen
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
| | - Mariann Fossum
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | | | - Ann Fruhling
- School of Interdisciplinary Informatics, College of Information Science and Technology, University of Nebraska, Omaha, USA
| | - Åshild Slettebø
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Systematic Review on the Effects of Serious Games and Wearable Technology Used in Rehabilitation of Patients With Traumatic Bone and Soft Tissue Injuries. Arch Phys Med Rehabil 2017; 99:1890-1899. [PMID: 29138050 DOI: 10.1016/j.apmr.2017.10.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 09/23/2017] [Accepted: 10/20/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the effects on functional outcomes and treatment adherence of wearable technology and serious games (ie, interactive computer applications with specific purposes useful in the "real world") currently used in physical rehabilitation of patients after traumatic bone and soft tissue injuries. DATA SOURCES PubMed, EMBASE, Cochrane Library, and Current Index to Nursing and Allied Health Literature were searched without publication date restrictions for the terms wearable, serious game, videogame or mobile application, and rehabilitation, exercise therapy, and physiotherapy. STUDY SELECTION The search yielded 2704 eligible articles, which were screened by 2 independent reviewers. Studies comparing serious games to standard therapy were included. DATA EXTRACTION Methodology and results of the studies were critically appraised in conformity with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SYNTHESIS Twelve articles were included, all of which tested "off-the-shelf" games. No studies on "wearable-controlled" games or games specifically developed for rehabilitation could be included. Medical conditions included postoperative rehabilitation and acute traumatic injuries. All studies were of low to moderate quality. Only 2 studies found beneficial effects of serious games compared to conventional therapy. One of 3 studies reporting pain scores found beneficial effects of serious games compared to physiotherapy. One of 5 trials reporting treatment adherence found a statistically significant advantage in the game group compared to conventional physiotherapy. Because of heterogeneity in study design and outcome measures, pooling of data was not possible. CONCLUSIONS Serious games seem a safe alternative or addition to conventional physiotherapy after traumatic bone and soft tissue injuries. Future research should determine their validity and effectiveness in rehabilitation therapy, next to their cost-effectiveness and effect on treatment adherence.
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Validation of a Cognitive Task Simulation and Rehearsal Tool for Open Carpal Tunnel Release. Arch Plast Surg 2017; 44:223-227. [PMID: 28573097 PMCID: PMC5447532 DOI: 10.5999/aps.2017.44.3.223] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 08/01/2016] [Accepted: 08/17/2016] [Indexed: 11/08/2022] Open
Abstract
Background Carpal tunnel release is one of the most common surgical procedures performed by hand surgeons. The authors created a surgical simulation of open carpal tunnel release utilizing a mobile and rehearsal platform app. This study was performed in order to validate the simulator as an effective training platform for carpal tunnel release. Methods The simulator was evaluated using a number of metrics: construct validity (the ability to identify variability in skill levels), face validity (the perceived ability of the simulator to teach the intended material), content validity (that the simulator was an accurate representation of the intended operation), and acceptability validity (willingness of the desired user group to adopt this method of training). Novices and experts were recruited. Each group was tested, and all participants were assigned an objective score, which served as construct validation. A Likert-scale questionnaire was administered to gauge face, content, and acceptability validity. Results Twenty novices and 10 experts were recruited for this study. The objective performance scores from the expert group were significantly higher than those of the novice group, with surgeons scoring a median of 74% and medical students scoring a median of 45%. The questionnaire responses indicated face, content, and acceptability validation. Conclusions This mobile-based surgical simulation platform provides step-by-step instruction for a variety of surgical procedures. The findings of this study help to demonstrate its utility as a learning tool, as we confirmed construct, face, content, and acceptability validity for carpal tunnel release. This easy-to-use educational tool may help bring surgical education to a new—and highly mobile—level.
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Jean Dit Gautier E, Bot-Robin V, Libessart A, Doucède G, Cosson M, Rubod C. Design of a Serious Game for Handling Obstetrical Emergencies. JMIR Serious Games 2016; 4:e21. [PMID: 28003175 PMCID: PMC5214697 DOI: 10.2196/games.5526] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 05/25/2016] [Accepted: 08/08/2016] [Indexed: 01/06/2023] Open
Abstract
Background The emergence of new technologies in the obstetrical field should lead to the development of learning applications, specifically for obstetrical emergencies. Many childbirth simulations have been recently developed. However, to date none of them have been integrated into a serious game. Objective Our objective was to design a new type of immersive serious game, using virtual glasses to facilitate the learning of pregnancy and childbirth pathologies. We have elaborated a new game engine, placing the student in some maternity emergency situations and delivery room simulations. Methods A gynecologist initially wrote a scenario based on a real clinical situation. He also designed, along with an educational engineer, a tree diagram, which served as a guide for dialogues and actions. A game engine, especially developed for this case, enabled us to connect actions to the graphic universe (fully 3D modeled and based on photographic references). We used the Oculus Rift in order to immerse the player in virtual reality. Each action in the game was linked to a certain number of score points, which could either be positive or negative. Results Different pathological pregnancy situations have been targeted and are as follows: care of spontaneous miscarriage, threat of preterm birth, forceps operative delivery for fetal abnormal heart rate, and reduction of a shoulder dystocia. The first phase immerses the learner into an action scene, as a doctor. The second phase ask the student to make a diagnosis. Once the diagnosis is made, different treatments are suggested. Conclusions Our serious game offers a new perspective for obstetrical emergency management trainings and provides students with active learning by immersing them into an environment, which recreates all or part of the real obstetrical world of emergency. It is consistent with the latest recommendations, which clarify the importance of simulation in teaching and in ongoing professional development.
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Affiliation(s)
- Estelle Jean Dit Gautier
- Department of Gynecology Surgery, Hopital Jeanne de Flandre, University of Lille, Lille cedex, France
| | | | | | - Guillaume Doucède
- Department of Gynecology Surgery, Hopital Jeanne de Flandre, University of Lille, Lille cedex, France
| | - Michel Cosson
- Department of Gynecology Surgery, Hopital Jeanne de Flandre, University of Lille, Lille cedex, France
| | - Chrystèle Rubod
- Department of Gynecology Surgery, Hopital Jeanne de Flandre, University of Lille, Lille cedex, France
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Royal K. "Face validity" is not a legitimate type of validity evidence! Am J Surg 2016; 212:1026-1027. [PMID: 27255779 DOI: 10.1016/j.amjsurg.2016.02.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 02/27/2016] [Indexed: 11/25/2022]
Abstract
The American Journal of Surgery (AJS) is a long-standing leader among surgery publications and has published high-quality research dating back to 1926. To preserve AJS's reputation, it is necessary to identify issues that may affect the journal, and subsequently the broader field of surgery, in a negative way, and attempt to resolve those issues. To that end, I would like to address the issue of citing "face validity" as a type of validity evidence. In a review of AJS articles since 2006, 30 articles have consisted of researchers citing face validity as part of their validity evidence. This is problematic because validity theorists (scholars who dedicate their careers to studying validity and what constitutes acceptable types of validity evidence) have universally agreed there is no such thing as "face validity". Thus, the purpose of this article is to encourage surgeons to study recent, and authoritative, works on validity theory, so they can better articulate the trustworthiness of their research findings and be more informed consumers of research.
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Affiliation(s)
- Kenneth Royal
- North Carolina State University, Clinical Sciences, 1060 William Moore Dr., Raleigh, NC 27607, USA.
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17
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Barsom EZ, Graafland M, Schijven MP. Systematic review on the effectiveness of augmented reality applications in medical training. Surg Endosc 2016; 30:4174-83. [PMID: 26905573 PMCID: PMC5009168 DOI: 10.1007/s00464-016-4800-6] [Citation(s) in RCA: 183] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 02/03/2016] [Indexed: 12/16/2022]
Abstract
Background Computer-based applications are increasingly used to support the training of medical professionals. Augmented reality applications (ARAs) render an interactive virtual layer on top of reality. The use of ARAs is of real interest to medical education because they blend digital elements with the physical learning environment. This will result in new educational opportunities. The aim of this systematic review is to investigate to which extent augmented reality applications are currently used to validly support medical professionals training. Methods PubMed, Embase, INSPEC and PsychInfo were searched using predefined inclusion criteria for relevant articles up to August 2015. All study types were considered eligible. Articles concerning AR applications used to train or educate medical professionals were evaluated. Results Twenty-seven studies were found relevant, describing a total of seven augmented reality applications. Applications were assigned to three different categories. The first category is directed toward laparoscopic surgical training, the second category toward mixed reality training of neurosurgical procedures and the third category toward training echocardiography. Statistical pooling of data could not be performed due to heterogeneity of study designs. Face-, construct- and concurrent validity was proven for two applications directed at laparoscopic training, face- and construct validity for neurosurgical procedures and face-, content- and construct validity in echocardiography training. In the literature, none of the ARAs completed a full validation process for the purpose of use. Conclusion Augmented reality applications that support blended learning in medical training have gained public and scientific interest. In order to be of value, applications must be able to transfer information to the user. Although promising, the literature to date is lacking to support such evidence.
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Affiliation(s)
- E Z Barsom
- Department of Surgery, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - M Graafland
- Department of Surgery, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.,Department of Surgery, Flevo Hospital, Almere, The Netherlands
| | - M P Schijven
- Department of Surgery, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
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18
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Jalink MB, Goris J, Heineman E, Pierie JPE, ten Cate Hoedemaker HO. Face validity of a Wii U video game for training basic laparoscopic skills. Am J Surg 2015; 209:1102-6. [DOI: 10.1016/j.amjsurg.2014.09.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 08/31/2014] [Accepted: 09/05/2014] [Indexed: 11/24/2022]
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Graafland M, Bemelman WA, Schijven MP. Appraisal of Face and Content Validity of a Serious Game Improving Situational Awareness in Surgical Training. J Laparoendosc Adv Surg Tech A 2015; 25:43-9. [DOI: 10.1089/lap.2014.0043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maurits Graafland
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - Willem A. Bemelman
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
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20
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Graafland M, Dankbaar M, Mert A, Lagro J, De Wit-Zuurendonk L, Schuit S, Schaafstal A, Schijven M. How to systematically assess serious games applied to health care. JMIR Serious Games 2014; 2:e11. [PMID: 25654163 PMCID: PMC4307812 DOI: 10.2196/games.3825] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 10/15/2014] [Accepted: 10/17/2014] [Indexed: 11/13/2022] Open
Abstract
The usefulness and effectiveness of specific serious games in the medical domain is often unclear. This is caused by a lack of supporting evidence on validity of individual games, as well as a lack of publicly available information. Moreover, insufficient understanding of design principles among the individuals and institutions that develop or apply a medical serious game compromises their use. This article provides the first consensus-based framework for the assessment of specific medical serious games. The framework provides 62 items in 5 main themes, aimed at assessing a serious game's rationale, functionality, validity, and data safety. This will allow caregivers and educators to make balanced choices when applying a serious game for healthcare purposes. Furthermore, the framework provides game manufacturers with standards for the development of new, valid serious games.
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Affiliation(s)
- Maurits Graafland
- Department of Surgery, Academic Medical Center, Amsterdam, Netherlands
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21
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Graafland M, Schraagen JMC, Boermeester MA, Bemelman WA, Schijven MP. Training situational awareness to reduce surgical errors in the operating room. Br J Surg 2014; 102:16-23. [DOI: 10.1002/bjs.9643] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 06/20/2014] [Accepted: 08/06/2014] [Indexed: 12/21/2022]
Abstract
Abstract
Background
Surgical errors result from faulty decision-making, misperceptions and the application of suboptimal problem-solving strategies, just as often as they result from technical failure. To date, surgical training curricula have focused mainly on the acquisition of technical skills. The aim of this review was to assess the validity of methods for improving situational awareness in the surgical theatre.
Methods
A search was conducted in PubMed, Embase, the Cochrane Library and PsycINFO® using predefined inclusion criteria, up to June 2014. All study types were considered eligible. The primary endpoint was validity for improving situational awareness in the surgical theatre at individual or team level.
Results
Nine articles were considered eligible. These evaluated surgical team crisis training in simulated environments for minimally invasive surgery (4) and open surgery (3), and training courses focused at training non-technical skills (2). Two studies showed that simulation-based surgical team crisis training has construct validity for assessing situational awareness in surgical trainees in minimally invasive surgery. None of the studies showed effectiveness of surgical crisis training on situational awareness in open surgery, whereas one showed face validity of a 2-day non-technical skills training course.
Conclusion
To improve safety in the operating theatre, more attention to situational awareness is needed in surgical training. Few structured curricula have been developed and validation research remains limited. Strategies to improve situational awareness can be adopted from other industries.
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Affiliation(s)
- M Graafland
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - J M C Schraagen
- Netherlands Organization for Applied Scientific Research (TNO), Soesterberg, The Netherlands
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Twente, The Netherlands
| | - M A Boermeester
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - W A Bemelman
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - M P Schijven
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
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van Hove PD, Verdaasdonk EGG, Dankelman J, Stassen LPS. Development and evaluation of an interactive simulation module to train the use of an electrosurgical device. J Laparoendosc Adv Surg Tech A 2014; 24:628-33. [PMID: 25010995 DOI: 10.1089/lap.2013.0579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The purpose of this study was to develop and evaluate an interactive Web-based training module for electrosurgery and use of an electrosurgical device. MATERIALS AND METHODS The training module consists of a theoretical part, a device tutorial, and an assessment. For evaluation, participants were recruited at the surgical departments from a university hospital and a non-university teaching hospital and were divided into a training group and a control group. All participants performed the same theoretical and practical tests. The training participants first completed the module before they performed the tests. The control participants immediately performed the tests. Results were compared between the training and control participants. To evaluate face validity, the training participants filled out a questionnaire on their opinion about the module. RESULTS In total, 39 participants were enrolled in the study: 20 in the training group and 19 in the control group. The training group answered significantly more theoretical questions correctly (15.7 versus 9.7; P<.001) and made significantly fewer errors in the practical test (2.2 versus 5.6; P=.007). The participants in the training group rated the usefulness and characteristics of the module with high marks. All of them indicated the module to be of additive value to surgical training programs. CONCLUSIONS Training with an interactive Web-based module has a positive effect on both theoretical and practical competence regarding electrosurgery and use of an electrosurgical device. This module was rated positively by the participants and was indicated to be a useful addition to surgical training programs.
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Affiliation(s)
- P Diederick van Hove
- 1 Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology , Delft, The Netherlands
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Graafland M, Bok K, Schreuder HWR, Schijven MP. A Multicenter Prospective Cohort Study on Camera Navigation Training for Key User Groups in Minimally Invasive Surgery. Surg Innov 2013; 21:312-9. [DOI: 10.1177/1553350613505714] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Untrained laparoscopic camera assistants in minimally invasive surgery (MIS) may cause suboptimal view of the operating field, thereby increasing risk for errors. Camera navigation is often performed by the least experienced member of the operating team, such as inexperienced surgical residents, operating room nurses, and medical students. The operating room nurses and medical students are currently not included as key user groups in structured laparoscopic training programs. A new virtual reality laparoscopic camera navigation (LCN) module was specifically developed for these key user groups. Methods. This multicenter prospective cohort study assesses face validity and construct validity of the LCN module on the Simendo virtual reality simulator. Face validity was assessed through a questionnaire on resemblance to reality and perceived usability of the instrument among experts and trainees. Construct validity was assessed by comparing scores of groups with different levels of experience on outcome parameters of speed and movement proficiency. Results. The results obtained show uniform and positive evaluation of the LCN module among expert users and trainees, signifying face validity. Experts and intermediate experience groups performed significantly better in task time and camera stability during three repetitions, compared to the less experienced user groups ( P < .007). Comparison of learning curves showed significant improvement of proficiency in time and camera stability for all groups during three repetitions ( P < .007). Conclusion. The results of this study show face validity and construct validity of the LCN module. The module is suitable for use in training curricula for operating room nurses and novice surgical trainees, aimed at improving team performance in minimally invasive surgery.
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Affiliation(s)
- Maurits Graafland
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - Kiki Bok
- Division of Woman & Baby, Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Henk W. R. Schreuder
- Division of Woman & Baby, Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Jalink MB, Goris J, Heineman E, Pierie JPEN, ten Cate Hoedemaker HO. Construct and concurrent validity of a Nintendo Wii video game made for training basic laparoscopic skills. Surg Endosc 2013; 28:537-42. [PMID: 24061627 DOI: 10.1007/s00464-013-3199-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 08/16/2013] [Indexed: 01/25/2023]
Abstract
BACKGROUND Virtual reality (VR) laparoscopic simulators have been around for more than 10 years and have proven to be cost- and time-effective in laparoscopic skills training. However, most simulators are, in our experience, considered less interesting by residents and are often poorly accessible. Consequently, these devices are rarely used in actual training. In an effort to make a low-cost and more attractive simulator, a custom-made Nintendo Wii game was developed. This game could ultimately be used to train the same basic skills as VR laparoscopic simulators ought to. Before such a video game can be implemented into a surgical training program, it has to be validated according to international standards. METHODS The main goal of this study was to test construct and concurrent validity of the controls of a prototype of the game. In this study, the basic laparoscopic skills of experts (surgeons, urologists, and gynecologists, n = 15) were compared to those of complete novices (internists, n = 15) using the Wii Laparoscopy (construct validity). Scores were also compared to the Fundamentals of Laparoscopy (FLS) Peg Transfer test, an already established assessment method for measuring basic laparoscopic skills (concurrent validity). RESULTS Results showed that experts were 111 % faster (P = 0.001) on the Wii Laparoscopy task than novices. Also, scores of the FLS Peg Transfer test and the Wii Laparoscopy showed a significant, high correlation (r = 0.812, P < 0.001). CONCLUSIONS The prototype setup of the Wii Laparoscopy possesses solid construct and concurrent validity.
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Affiliation(s)
- M B Jalink
- Department of Surgery, University Medical Center Groningen, University of Groningen, De Brug, room 5.062, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands,
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Graafland M, Schraagen JM, Schijven MP. Systematic review of serious games for medical education and surgical skills training. Br J Surg 2012; 99:1322-30. [PMID: 22961509 DOI: 10.1002/bjs.8819] [Citation(s) in RCA: 209] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
The application of digital games for training medical professionals is on the rise. So-called ‘serious’ games form training tools that provide a challenging simulated environment, ideal for future surgical training. Ultimately, serious games are directed at reducing medical error and subsequent healthcare costs. The aim was to review current serious games for training medical professionals and to evaluate the validity testing of such games.
Methods
PubMed, Embase, the Cochrane Database of Systematic Reviews, PsychInfo and CINAHL were searched using predefined inclusion criteria for available studies up to April 2012. The primary endpoint was validation according to current criteria.
Results
A total of 25 articles were identified, describing a total of 30 serious games. The games were divided into two categories: those developed for specific educational purposes (17) and commercial games also useful for developing skills relevant to medical personnel (13). Pooling of data was not performed owing to the heterogeneity of study designs and serious games. Six serious games were identified that had a process of validation. Of these six, three games were developed for team training in critical care and triage, and three were commercially available games applied to train laparoscopic psychomotor skills. None of the serious games had completed a full validation process for the purpose of use.
Conclusion
Blended and interactive learning by means of serious games may be applied to train both technical and non-technical skills relevant to the surgical field. Games developed or used for this purpose need validation before integration into surgical teaching curricula.
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Affiliation(s)
- M Graafland
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
| | - J M Schraagen
- Netherlands Organization for Applied Scientific Research, Soesterberg, The Netherlands
| | - M P Schijven
- Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands
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Tjiam IM, Schout BMA, Hendrikx AJ, Muijtjens AM, Scherpbier AJ, Witjes JA, Van Der Vleuten CP. Program for laparoscopic urological skills assessment: Setting certification standards for residents. MINIM INVASIV THER 2012; 22:26-32. [DOI: 10.3109/13645706.2012.686918] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Dolmans VE, Schout BM, de Beer NA, Bemelmans BL, Scherpbier AJ, Hendrikx AJ. The Virtual Reality Endourologic Simulator Is Realistic and Useful for Educational Purposes. J Endourol 2009; 23:1175-81. [DOI: 10.1089/end.2008.0487] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Barbara M.A. Schout
- Catharina Hospital Eindhoven, Eindhoven, The Netherlands
- VU Medical Center, Amsterdam, The Netherlands
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Sugiono M, Teber D, Anghel G, Gözen AS, Stock C, Hruza M, Frede T, Klein J, Rassweiler JJ. Assessing the Predictive Validity and Efficacy of a Multimodal Training Programme for Laparoscopic Radical Prostatectomy (LRP). Eur Urol 2007; 51:1332-9; discussion 1340. [PMID: 17137707 DOI: 10.1016/j.eururo.2006.11.029] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2006] [Accepted: 11/09/2006] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To assess the predictive validity (ability to correlate to real-life environment) and efficacy of a training programme for laparoscopic radical prostatectomy (LRP), based on a structured and progressive pelvitrainer component with hands-on clinical training in the operating room (OR). METHODS Prospective data on 500 LRP cases were analysed with 80 excluded due to incomplete records. The operation was divided into multiple steps. Times for these steps were compared among 11 surgeons with different laparoscopic expertise (first-, second-, and third-generation surgeons in order of decreasing experience) and correlated to times for specific exercises on the pelvitrainer that simulated particular steps. Perioperative parameters were also evaluated among the three groups. RESULTS Pelvitrainer times achieved by trainees (third-generation surgeons) did not differ significantly with times for corresponding steps of LRP. There was also no significant difference for total OR time between the second- and third-generation surgeons (205 and 207 min, respectively; p>0.05) although the time for the first-generation surgeons was faster than both (176 min). Short-term quality indicators for first, second, and third generations included transfusion rates (2.3%, 2.4%, and 2.6%, respectively), positive margin rates (20.3%, 21.5%, and 23.0%) and complications, which did not differ significantly among the generations although the first-generation surgeons had the lowest rates. CONCLUSIONS A carefully designed training programme that incorporates both pelvitrainer and mentor-based operative training is essential for the effective and safe transfer of skills and knowledge required to learn LRP.
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Affiliation(s)
- Marto Sugiono
- Department of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, Am Gesundbrunnen 20, D-77074 Heidelberg, Germany
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