TY - JOUR
T1 - Effect of real-time virtual reality-based teaching cues on learning needle passing for robot-assisted minimally invasive surgery
T2 - a randomized controlled trial
AU - Malpani, Anand
AU - Vedula, S. Swaroop
AU - Lin, Henry C.
AU - Hager, Gregory D.
AU - Taylor, Russell H.
N1 - Funding Information:
Thanks to the Link Foundation Fellowship for Advanced Simulation and Training awarded to Anand Malpani. This work is part of Anand Malpani’s Ph.D. Thesis [].
Funding Information:
We thank Anusha Balan, Sina Parastegari, Prasad, and Ashwin from Intuitive Surgical Inc. (ISI, Sunnyvale, California) for their help with the dVSim. We thank Simon DiMaio (ISI) for his feedback and helpful inputs. We thank Anthony Jarc (ISI) for help with the study IRB logistics. We thank Umut and Daniel from SenseGraphics AB (Kista, Sweden) for their support related to the H3DAPI.
Funding Information:
Anand Malpani was supported through a Link Foundation fellowship award for advanced simulation and training. Acknowledgements
Publisher Copyright:
© 2020, CARS.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Purpose: Current virtual reality-based (VR) simulators for robot-assisted minimally invasive surgery (RAMIS) training lack effective teaching and coaching. Our objective was to develop an automated teaching framework for VR training in RAMIS. Second, we wanted to study the effect of such real-time teaching cues on surgical technical skill acquisition. Third, we wanted to assess skill in terms of surgical technique in addition to traditional time and motion efficiency metrics. Methods: We implemented six teaching cues within a needle passing task on the da Vinci Skills Simulator platform (noncommercial research version). These teaching cues are graphical overlays designed to demonstrate ideal surgical technique, e.g., what path to follow while passing needle through tissue. We created three coaching modes: teach (continuous demonstration), metrics (demonstration triggered by performance metrics), and user (demonstration upon user request). We conducted a randomized controlled trial where the experimental group practiced using automated teaching and the control group practiced in a self-learning manner without automated teaching. Results: We analyzed data from 30 participants (14 in experimental and 16 in control group). After three practice repetitions, control group showed higher improvement in time and motion efficiency, while experimental group showed higher improvement in surgical technique compared to their baseline measurements. The experimental group showed more improvement than the control group on a surgical technique metric (at what angle is needle grasped by an instrument), and the difference between groups was statistically significant. Conclusion: In a pilot randomized controlled trial, we observed that automated teaching cues can improve the performance of surgical technique in a VR simulator for RAMIS needle passing. Our study was limited by its recruitment of nonsurgeons and evaluation of a single configuration of coaching modes.
AB - Purpose: Current virtual reality-based (VR) simulators for robot-assisted minimally invasive surgery (RAMIS) training lack effective teaching and coaching. Our objective was to develop an automated teaching framework for VR training in RAMIS. Second, we wanted to study the effect of such real-time teaching cues on surgical technical skill acquisition. Third, we wanted to assess skill in terms of surgical technique in addition to traditional time and motion efficiency metrics. Methods: We implemented six teaching cues within a needle passing task on the da Vinci Skills Simulator platform (noncommercial research version). These teaching cues are graphical overlays designed to demonstrate ideal surgical technique, e.g., what path to follow while passing needle through tissue. We created three coaching modes: teach (continuous demonstration), metrics (demonstration triggered by performance metrics), and user (demonstration upon user request). We conducted a randomized controlled trial where the experimental group practiced using automated teaching and the control group practiced in a self-learning manner without automated teaching. Results: We analyzed data from 30 participants (14 in experimental and 16 in control group). After three practice repetitions, control group showed higher improvement in time and motion efficiency, while experimental group showed higher improvement in surgical technique compared to their baseline measurements. The experimental group showed more improvement than the control group on a surgical technique metric (at what angle is needle grasped by an instrument), and the difference between groups was statistically significant. Conclusion: In a pilot randomized controlled trial, we observed that automated teaching cues can improve the performance of surgical technique in a VR simulator for RAMIS needle passing. Our study was limited by its recruitment of nonsurgeons and evaluation of a single configuration of coaching modes.
KW - Evaluation and validation
KW - Randomized controlled trial
KW - Surgical robots
KW - Surgical training and assessment
KW - Virtual reality
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U2 - 10.1007/s11548-020-02156-5
DO - 10.1007/s11548-020-02156-5
M3 - Article
C2 - 32385598
AN - SCOPUS:85084511418
SN - 1861-6410
VL - 15
SP - 1187
EP - 1194
JO - Computer-Assisted Radiology and Surgery
JF - Computer-Assisted Radiology and Surgery
IS - 7
ER -