A Surgical Virtual Learning Environment

A computer based Virtual Learning Environment is proposed for training and evaluating novice surgeons. Although this Virtual Learning Environments is thought to be useful in other learning situations as well, especially where knowledge of different complex procedures and the ability to correctly assess a complex situation is critical, in this project we specifically focus on vascular surgery. This environment will be developed as part of the DIME project (Distributed Interactive Medical Exploratory). We are building this Virtual Learning Environment using a new navigational metaphor, which affords modeling the learning process, rather than focusing solely on modeling the operating room. This 'navigational metaphor' can be thought of as an semi-threedimensional interface to a database containing multimedia fragments and expert annotations of the knowledge domain under study

Integrating Technical and Nontechnical Skills in Hands-On Surgical Training

Safe and effective surgery requires high-quality technical and nontechnical skills. Although the importance of nontechnical skills has become increasingly clear, today’s surgical curricula still lack formal training in nontechnical skills. In this chapter, we discuss how to integrate technical and nontechnical skills training into surgical curricula and provide strategies on how to teach both skill sets concurrently in a hands-on setting

Surgical Education Feedback activities of instructors during a trauma surgery course

Abstract BACKGROUND: The aim of this study was to examine the quality and quantity of feedback and instruction from faculty members during an acute trauma surgery team training using a newly designed observational feedback instrument. METHODS: During the training, 11 operating teams, each consisting of 1 instructor coaching 2 trainees, were videotaped and audiotaped. Forty-five minutes of identical operating scenarios were reviewed and analyzed. Using a new observational feedback instrument, feedback and instruction, containing different levels of specific information related to technical and nontechnical skills, were noted. RESULTS: Instructors more often provided instruction (25.8 6 10.6 times) than feedback (4.4 6 3.5 times). Most feedback and instruction contained either nonspecific or less specific information and referred to technical skills. Instructors addressed communication skills more specifically. CONCLUSIONS: Coaching by faculty members predominantly contained unspecific instructions regarding technical skills. The observational feedback instrument enabled scoring of the coaching activities. Ó 2013 Elsevier Inc. All rights reserved. Instructor feedback is essential for acquiring surgical skills in practical training situations

Visuo-spatial ability in colonoscopy simulator training

Visuo-spatial ability is associated with a quality of performance in a variety of surgical and medical skills. However, visuo-spatial ability is typically assessed using Visualization tests only, which led to an incomplete understanding of the involvement of visuo-spatial ability in these skills. To remedy this situation, the current study investigated the role of a broad range of visuo-spatial factors in colonoscopy simulator training. Fifteen medical trainees (no clinical experience in colonoscopy) participated in two psycho-metric test sessions to assess four visuo-spatial ability factors. Next, participants trained flexible endoscope manipulation, and navigation to the cecum on the GI Mentor II simulator, for four sessions within 1 week. Visualization, and to a lesser degree Spatial relations were the only visuo-spatial ability factors to correlate with colonoscopy simulator performance. Visualization additionally covaried with learning rate for time on task on both simulator tasks. High Visualization ability indicated faster exercise completion. Similar to other endoscopic procedures, performance in colonoscopy is positively associated with Visualization, a visuo-spatial ability factor characterized by the ability to mentally manipulate complex visuo-spatial stimuli. The complexity of the visuo-spatial mental transformations required to successfully perform colonoscopy is likely responsible for the challenging nature of this technique, and should inform training- and assessment design. Long term training studies, as well as studies investigating the nature of visuo-spatial complexity in this domain are needed to better understand the role of visuo-spatial ability in colonoscopy, and other endoscopic techniques

See me, touch me, heal me : the role of visuo-spatial ability in virtual anatomical learning and surgical simulator training

Medical learning and training are fields in transition. Catalyst in this change is the introduction of digital technology, for example in the form of simulator technology in surgical training, and virtual learning environments in anatomical learning. The primary aim of this thesis is to help understand and optimize this new situation. More specifically, the mediating role of cognitive abilities such as visuo-spatial ability in this learning and training is investigated. Visuo-spatial ability refers to the human cognitive ability to form, retrieve, and manipulate mental models of a visual and spatial nature\ud \ud \ud \ud The first three empirical chapters report experiments investigating the effects of stereopsis, dynamic exploration, and visuo-spatial ability on virtual anatomical learning. Stereopsis refers to the visual experience of space derived from slightly different patterns of light being simultaneously received by the eyes. One can dynamically explore virtual objects if it is possible to interactively change one's viewpoint with respect to such objects in real time. In virtual anatomical learning environments, people of low visuo-spatial ability benefit from a combination of computer-implemented stereopsis and dynamic exploration.\ud \ud \ud \ud The last two experimental chapters investigate how the development of endoscopic skill correlates with the major five individual factors that together form visuo-spatial ability. Endoscopy refers to those surgical techniques that are characterized by the use of a small camera introduced to the body to provide visual feedback, in order to minimize surgery related trauma. The visuo-spatial factor of Visualization is more important to endoscopic than other visuo-spatial factors. Visualization is characterized by a high sensitivity for visuo-spatial complexity. More work is needed to understand visuo-spatial complexity in this context (or, indeed, any context).\u

The Contribution of Dynamic Exploration to Virtual Anatomical Learning

Virtual Learning Environments are increasingly becoming part of the medical curriculum. In a previous study we (luursema et al., 2006) found that a combination of computer-implemented stereopsis (visual depth through seeing with both eyes) and dynamic exploration (being able to continuously change one's viewpoint relative to the studied objects in real time) is beneficial to anatomical learning, especially for subjects of low visuo spatial ability (the ability to form, retrieve, and manipulate mental representations of a visuo-spatial nature). A follow-up study (luursema et al., 2008) found the contribution of computer-implemented stereopsis to this effect to be small but significant. The present experiment investigated the contribution of dynamic exploration to anatomical learning by means of a virtual learning environment. Seventy participants were tested for visuo-spatial ability and were grouped in pairs matched for this ability. One individual of the pair actively manipulated a 3D reconstruction of the human abdomen; the other individual passively watched the interactions of the first individual on a separate screen. Learning was assessed by two anatomical learning tests. Dynamic exploration provided a small but significant benefit to anatomical learning

Laparoscopic simulator performance and learning curves under different optical angles

Abstract Background Deviated optical angles create visuospatial and psychomotor challenges during laparoscopic procedures, resulting in delayed operative time and possibly adverse events. If it is possible to train the skills needed to work under these deviated optical angles, this could benefit procedure time and patient safety. This study investigates the influence of the optical angle on development of basic laparoscopic surgical skills. Methods A total of 58 medical students performed a four-session laparoscopic training course on a Virtual Reality Simulator. During each session, they performed an identical task under optical angles of 0°, 45° and − 45°. Performance parameters of task duration and damage were compared between the optical angles to investigate the effect of optical angle on performance development. The 4th session performance was compared to the 2nd session performance for each angle to determine improvement. Results Participants performed the task significantly faster under the 0° optical angle compared to the plus and minus 45° optical angles during the last three sessions (z between − 2.95 and − 2.09, p < .05). Participants improved significantly and similarly for task duration during the training course under all optical angles. At the end of the training course however significant performance differences between the zero and plus/minus 45 optical angles remained. Performance for damage did not improve and was not affected by optical angle throughout the course. Conclusion Dedicated virtual reality training improves laparoscopic basic skills performance under deviated optical angles as it leads to shorter task duration, however a lasting performance impairment compared to the 0° optical angle remained. Training for performing under deviating optical angles can potentially shorter the learning curve in the operating room