The importance of expert feedback during endovascular simulator training
The importance of expert feedback during endovascular simulator training
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DOI：
10.1016/j.jvs.2011.01.058
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发表时间：
2011-07-01
影响因子：
4.3
通讯作者：
Moneley, Daragh
中科院分区：
文献类型：
--
作者：
Boyle, Emily;O'Keeffe, Dara A.;Moneley, Daragh
目的：复杂的血管内技术在临床环境中很难获得。虚拟现实(VR)模拟器培训是当前培训课程的一个有价值的补充，但如果没有专家培训师是否有好处？方法：18名血管内新手在血管介入性外科训练器模拟器上进行了肾动脉血管成形术/支架(RAS)。他们被随机分为三组：A组(n=6，对照组)，无操作反馈；B组(n=6，非专家反馈)，每次手术后由非专家协调员反馈；C组(n=6，专家反馈)，每次手术后由咨询血管外科医生反馈。每个学员都完成了六次RAS。模拟器测量的性能指标包括操作和透视时间、对比度、球囊放置的准确性和处理错误。临床差错也通过盲法视频评估来衡量。数据用SPSS Version 15软件进行分析。结果：在6个试验中观察到了清晰的学习曲线。三组在一般性能指标上没有显著差异，但C组的错误比A组(P=.009)或B组(P=.004)少。基于视频的错误评估显示，B组和C组的成绩好于A组(分别为P=.002和P=.000)。结论：在没有专业训练师的情况下，对新手进行VR模拟器培训可以显著提高总体成绩。特定于程序的定性指标通过专家反馈得到改进，但非专家辅导员也可以提高培训质量，可能是专家临床教师的一种有价值的选择。(《花瓶外科杂志》2011；54：240-8)
Objectives: Complex endovascular skills are difficult to obtain in the clinical environment. Virtual reality (VR) simulator training is a valuable addition to current training curricula, but is there a benefit in the absence of expert trainers?Methods: Eighteen endovascular novices performed a renal artery angioplasty/stenting (RAS) on the Vascular Interventional Surgical Trainer simulator. They were randomized into three groups: Group A (n = 6, control), no performance feedback; Group B (n = 6, nonexpert feedback), feedback after every procedure from a nonexpert facilitator; and Group C (n = 6, expert feedback), feedback after every procedure from a consultant vascular surgeon. Each trainee completed RAS six times. Simulator-measured performance metrics included procedural and fluoroscopy time, contrast volume, accuracy of balloon placement, and handling errors. Clinical errors were also measured by blinded video assessment. Data were analyzed using SPSS version 15.Results: A clear learning curve was observed across the six trials. There were no significant differences between the three groups for the general performance metrics, but Group C made fewer errors than Groups A (P=.009) or B (P=.004). Video-based error assessment showed that Groups B and C performed better than Group A (P=.002 and P=.000, respectively).Conclusion: VR simulator training for novices can significantly improve general performance in the absence of expert trainers. Procedure-specific qualitative metrics are improved with expert feedback, but nonexpert facilitators can also enhance the quality of training and may represent a valuable alternative to expert clinical faculty. (J Vase Surg 2011;54:240-8.)