Skip to main content

Advertisement

SpringerLink
Log in

European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Virtual reality (VR) simulators have been demonstrated to improve basic psychomotor skills in endoscopic surgery. The exercise configuration settings used for validation in studies published so far are default settings or are based on the personal choice of the tutors. The purpose of this study was to establish consensus on exercise configurations and on a validated training program for a virtual reality simulator, based on the experience of international experts to set criterion levels to construct a proficiency-based training program.

Methods

A consensus meeting was held with eight European teams, all extensively experienced in using the VR simulator. Construct validity of the training program was tested by 20 experts and 60 novices. The data were analyzed by using the t test for equality of means.

Results

Consensus was achieved on training designs, exercise configuration, and examination. Almost all exercises (7/8) showed construct validity. In total, 50 of 94 parameters (53%) showed significant difference.

Conclusions

A European, multicenter, validated, training program was constructed according to the general consensus of a large international team with extended experience in virtual reality simulation. Therefore, a proficiency-based training program can be offered to training centers that use this simulator for training in basic psychomotor skills in endoscopic surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aggarwal R, Ward J, Balasundaram I, Sains P, Athanasiou T, Darzi A (2007) Proving the effectiveness of virtual reality simulation for training in laparoscopic surgery. Ann Surg 5:771–779

    Article  Google Scholar 

  2. Ahlberg G, Heikkinen T, Iselius L, Leijonmarck CE, Rutqvist J, Arvidsson D (2002) Does training in a virtual reality simulator improve surgical performance? Surg Endosc 1:126–129

    Article  Google Scholar 

  3. Ahlberg G, Enochsson L, Gallagher AG, Hedman L, Hogman C, McClusky DA III, Ramel S, Smith CD, Arvidsson D (2007) Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. Am J Surg 6:797–804

    Article  Google Scholar 

  4. Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 2:146–150

    Article  Google Scholar 

  5. Gurusamy K, Aggarwal R, Palanivelu L, Davidson BR (2008) Systematic review of randomized controlled trials on the effectiveness of virtual reality training for laparoscopic surgery. Br J Surg 9:1088–1097

    Article  Google Scholar 

  6. Hyltander A, Liljegren E, Rhodin PH, Lonroth H (2002) The transfer of basic skills learned in a laparoscopic simulator to the operating room. Surg Endosc 9:1324–1328

    Article  Google Scholar 

  7. Kundhal PS, Grantcharov TP (2009) Psychomotor performance measured in a virtual environment correlates with technical skills in the operating room. Surg Endosc 3:645–649

    Article  Google Scholar 

  8. Larsen CR, Soerensen JL, Grantcharov TP, Dalsgaard T, Schouenborg L, Ottosen C, Schroeder TV, Ottesen BS (2009) Effect of virtual reality training on laparoscopic surgery: randomised controlled trial. BMJ 14:b1802

  9. Schijven MP, Jakimowicz JJ, Broeders IA, Tseng LN (2005) The Eindhoven laparoscopic cholecystectomy training course-improving operating room performance using virtual reality training: results from the first E.A.E.S. accredited virtual reality trainings curriculum. Surg Endosc 9:1220–1226

    Article  Google Scholar 

  10. Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 4:458–463

    Article  Google Scholar 

  11. Aggarwal R, Grantcharov TP, Eriksen JR, Blirup D, Kristiansen VB, Funch-Jensen P, Darzi A (2006) An evidence-based virtual reality training program for novice laparoscopic surgeons. Ann Surg 2:310–314

    Article  Google Scholar 

  12. Duffy AJ, Hogle NJ, McCarthy H, Lew JI, Egan A, Christos P, Fowler DL (2005) Construct validity for the LAPSIM laparoscopic surgical simulator. Surg Endosc 3:401–405

    Article  Google Scholar 

  13. Eriksen JR, Grantcharov T (2005) Objective assessment of laparoscopic skills using a virtual reality stimulator. Surg Endosc 9:1216–1219

    Article  Google Scholar 

  14. Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J (2003) Learning curves and impact of previous operative experience on performance on a virtual reality simulator to test laparoscopic surgical skills. Am J Surg 2:146–149

    Article  Google Scholar 

  15. Sherman V, Feldman LS, Stanbridge D, Kazmi R, Fried GM (2005) Assessing the learning curve for the acquisition of laparoscopic skills on a virtual reality simulator. Surg Endosc 5:678–682

    Article  Google Scholar 

  16. van Dongen KW, Tournoij E, van der Zee, Schijven MP, Broeders IA (2007) Construct validity of the LapSim: can the LapSim virtual reality simulator distinguish between novices and experts? Surg Endosc 21(8):1413–1417

  17. Panait L, Bell RL, Roberts KE, Duffy AJ (2008) Designing and validating a customized virtual reality-based laparoscopic skills curriculum. J Surg Educ 6:413–417

    Article  Google Scholar 

  18. Aggarwal R, Crochet P, Dias A, Misra A, Ziprin P, Darzi A (2009) Development of a virtual reality training curriculum for laparoscopic cholecystectomy. Br J Surg 9:1086–1093

    Article  Google Scholar 

  19. Verdaasdonk EG, Dankelman J, Lange JF, Stassen LP (2008) Incorporation of proficiency criteria for basic laparoscopic skills training: how does it work? Surg Endosc 12:2609–2615

    Article  Google Scholar 

  20. Verdaasdonk EG, Stassen LP, van Wijk RP, Dankelman J (2007) The influence of different training schedules on the learning of psychomotor skills for endoscopic surgery. Surg Endosc 2:214–219

    Article  Google Scholar 

  21. Mackay S, Morgan P, Datta V, Chang A, Darzi A (2002) Practice distribution in procedural skills training: a randomized controlled trial. Surg Endosc 6:957–961

    Article  Google Scholar 

  22. Munz Y, Almoudaris AM, Moorthy K, Dosis A, Liddle AD, Darzi AW (2007) Curriculum-based solo virtual reality training for laparoscopic intracorporeal knot tying: objective assessment of the transfer of skill from virtual reality to reality. Am J Surg 6:774–783

    Article  Google Scholar 

  23. Schijven MP, Jakimowicz J (2004) The learning curve on the Xitact LS 500 laparoscopy simulator: profiles of performance. Surg Endosc 1:121–127

    Article  Google Scholar 

  24. Aggarwal R, Grantcharov T, Moorthy K, Hance J, Darzi A (2006) A competency-based virtual reality training curriculum for the acquisition of laparoscopic psychomotor skill. Am J Surg 1:128–133

    Article  Google Scholar 

Download references

Acknowledgment

The authors thank R. Aggarwal of the Imperial College of London for sharing his knowledge and for his collaboration during the consensus meeting.

Disclosures

Drs. Koen van Dongen, Dr. Gunnar Ahlberg, Prof. Dr. Luigi Bonavina, Dr. Fiona Carter, Dr. Teodor Grantcharov, Dr. Marlies Schijven, Dr. Alessandro Stefani, Prof. Dr. David van der Zee, and Prof. Dr. Ivo Broeders have no conflicts of interest or financial ties to disclose. Dr. Anders Hyltander was founder and director of Surgical Science, Sweden, from 1999 until 2004. At this moment he is senior advisor to this company.

Author information

Authors and Affiliations

  1. University Medical Centre, Utrecht, The Netherlands

    Koen W. van Dongen

  2. TweeSteden Hospital, Tilburg, The Netherlands

    Koen W. van Dongen

  3. Karolinska Hospital, Stockholm, Sweden

    Gunnar Ahlberg

  4. University of Milan, Milan, Italy

    Luigi Bonavina

  5. Yeovil District Hospital, Yeovil, UK

    Fiona J. Carter

  6. Glostrup Hospital, Copenhagen, Denmark

    Teodor P. Grantcharov

  7. University of Toronto, St. Michael’s Hospital, Toronto, Canada

    Teodor P. Grantcharov

  8. Sahlgrenska Hospital, Goteborg, Sweden

    Anders Hyltander

  9. Academic Medical Centre, Amsterdam, The Netherlands

    Marlies P. Schijven

  10. Cisanello Hospital, Pisa, Italy

    Alessandro Stefani

  11. Wilhelmina Children’s Hospital, Utrecht, The Netherlands

    David C. van der Zee

  12. Meander Medical Centre, Amersfoort, The Netherlands

    Ivo A. M. J. Broeders

  13. Twente University, Institute of Technical Medicine, Drienerlolaan 1 Enschede (Noordhorst 120), PO box 217, 7500 AE, Enschede, The Netherlands

    Ivo A. M. J. Broeders

Authors
  1. Koen W. van Dongen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gunnar Ahlberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luigi Bonavina
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fiona J. Carter
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Teodor P. Grantcharov
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anders Hyltander
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marlies P. Schijven
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alessandro Stefani
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. David C. van der Zee
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ivo A. M. J. Broeders
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ivo A. M. J. Broeders.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van Dongen, K.W., Ahlberg, G., Bonavina, L. et al. European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills. Surg Endosc 25, 166–171 (2011). https://doi.org/10.1007/s00464-010-1151-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-010-1151-6

Keywords

Search

Navigation