Bimanual Psychomotor Performance in Neurosurgical Resident Applicants Assessed Using NeuroTouch, a Virtual Reality Simulator
Bimanual Psychomotor Performance in Neurosurgical Resident Applicants Assessed Using NeuroTouch, a Virtual Reality Simulator
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DOI：
10.1016/j.jsurg.2016.04.013
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发表时间：
2016-11-01
影响因子：
2.9
通讯作者：
Del Maestro, Rolando F.
中科院分区：
文献类型：
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作者：
Winkler-Schwartz, Alexander;Bajunaid, Khalid;Del Maestro, Rolando F.
目的：目前神经外科住院医师的选择方法没有包括双手心理表现的客观测量。基于计算机的模拟的进步提供了在无风险环境中进行复杂的模拟神经外科任务期间，评估未接受手术的人群的认知和心理技能的机会。本试验性研究旨在回答3个问题：（1）使用NeuroTouch的神经外科住院医师申请人在双手心理表现方面有何差异？(2)在申请人中是否有特别熟练的医学生？（3）既往手术暴露对手术操作是否有影响？设计：指导参与者切除3个视觉外观、硬度和随机出血点相同的模拟脑肿瘤。使用经验证的第1级、第2级和高级第2级指标评估双手精神活动表现。人口统计学数据包括神经外科择期手术和手术前暴露的周数。设置：这项试点研究是在加拿大蒙特利尔麦吉尔大学神经外科住院医师访谈后立即在麦吉尔神经外科模拟研究和培训中心进行的。参与者：所有17名接受采访的医学生被要求参加，其中16人同意。性能聚集在可定义的顶部，中间和底部组与所有指标的显着差异。在单变量分析中，增加播放音乐的时间、增加申请人自我评估的技术技能、高自信的自我评价以及增加皮肤闭合在统计学上影响性能。一个趋势，为两个自评增加手术室的信心和增加周的神经外科暴露于增加失血量的多变量analysis.CONCLUSIONS：模拟技术识别神经外科住院医师申请人具有不同水平的技术能力。这些结果提供了信息的研究正在开发的纵向研究的收购，发展和维护的心理技能。技术能力定制的培训计划，最大限度地提高个人居民双手心理训练依赖于不断更新和验证的指标，从虚拟现实模拟研究应探讨。(C)2016年在外科手术项目主任协会。爱思唯尔公司出版All rights reserved.
OBJECTIVE: Current selection methods for neurosurgical residents fail to include objective measurements of bimanual psychomotor performance. Advancements in computer based simulation provide opportunities to assess cognitive and psychomotor skills in surgically naive populations during complex simulated neurosurgical tasks in risk-free environments. This pilot study was designed to answer 3 questions: (1) What are the differences in bimanual psychomotor performance among neurosurgical residency applicants using NeuroTouch? (2) Are there exceptionally skilled medical students in the applicant cohort? and (3) Is there an influence of previous surgical exposure on surgical performance?DESIGN: Participants were instructed to remove 3 simulated brain tumors with identical visual appearance, stiffness, and random bleeding points. Validated tier 1, tier 2, and advanced tier 2 metrics were used to assess bimanual psychomotor performance. Demographic data included weeks of neurosurgical elective and prior operative exposure.SETTING: This pilot study was carried out at the McGill Neurosurgical Simulation Research and Training Center immediately following neurosurgical residency interviews at McGill University, Montreal, Canada.PARTICIPANTS: All 17 medical students interviewed were asked to participate, of which 16 agreed.RESULTS: Performances were clustered in definable top, middle, and bottom groups with significant differences for all metrics. Increased time spent playing music, increased applicant self-evaluated technical skills, high self-ratings of confidence, and increased skin closures statistically influenced performance on univariate analysis. A trend for both self-rated increased operating room confidence and increased weeks of neurosurgical exposure to increased blood loss was seen in multivariate analysis.CONCLUSIONS: Simulation technology identifies neurosurgical residency applicants with differing levels of technical ability. These results provide information for studies being developed for longitudinal studies on the acquisition, development, and maintenance of psychomotor skills. Technical abilities customized training programs that maximize individual resident bimanual psychomotor training dependant on continuously updated and validated metrics from virtual reality simulation studies should be explored. (C) 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.