Virtual reality bronchoscopy simulation - A revolution in procedural training
Virtual reality bronchoscopy simulation - A revolution in procedural training
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DOI：
10.1378/chest.120.4.1333
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发表时间：
2001-10-01
期刊：
影响因子：
9.6
通讯作者：
Galbraith, O
中科院分区：
文献类型：
--
作者：
Colt, HG;Crawford, SW;Galbraith, O
背景：在航空业，培训成本高昂，必须避免操作员失误。因此，在飞行员承担飞行责任之前，虚拟现实(NR)通常被用来通过模拟学习手工和技术技能。在医学领域，还必须掌握手工和技术技能，以熟练地进行有创手术，如柔性纤维支气管镜检查(FFB)。直到最近，FFB和其他内窥镜手术的培训都是在真实患者的工作中进行的。我们假设新手实习生使用名词短语。技能中心可以迅速获得基本技能，其结果将优于传统方式培训的高级实习生。方法：我们前瞻性地研究了5名进入肺部和重症护理医学培训计划的支气管镜新手。他们被教导使用NCR支气管镜技能中心进行柔性支气管镜检查；在4h的集体指导和4h的个人无监督练习之前和之后，使用技能中心和无生命的气道模型测试灵活性、速度和准确性。结果与4名熟练医生在2年培训期间至少进行了200次支气管镜检查的对照组的结果进行了比较。使用学生t检验比较无生命模型和VR支气管镜模拟器研究组和对照组的平均分数。训练前和训练后的测试分数采用痛苦t检验进行比较。为了比较培训后新手和熟练医生的分数，使用了未配对的双样本t检验。结果：在两个模型中，新手都显著提高了他们的灵巧度和准确性。与训练前相比，训练后错过的节段更少，与支气管壁的接触也更少。在没有显示呼吸道解剖结构的情况下，在速度或总时间方面没有统计上的显著改善。经过培训，新手的表现与熟练的医生持平或超过熟练医生。新手进行了更彻底的检查，在无生命和虚拟模拟模型中遗漏的节段明显减少。结论：使用虚拟支气管镜模拟器的短期、专注的指导和无人监督的练习使新手能够获得与具有多年经验的同事类似的手动和技术水平的诊断支气管镜检查。这些技能在传统的无生命的呼吸道训练模型中很容易复制，这表明它们也可以翻译为指导患者护理。
Background: In the airline industry,, training is costly and operator error must be avoided. Therefore, virtual reality (NR) is routinely used to lean manual and technical skills through simulation before pilots assume flight responsibilities. In the field of medicine, manual and technical skills must also be acquired to competently, perform invasive procedures such as flexible fiberoptic bronchoscopy (FFB). Until recently, training in FFB and other endoscopic procedures has occurred on the job in real patients. We hypothesized that novice trainees using a NP. skill center could rapidly acquire basic skills, and that results would compare favorably with those of senior trainees trained in the conventional manner.Methods: We prospectively studied five novice bronchoscopists entering a pulmonary and critical care medicine training program. They were taught to perform inspection flexible bronchoscopy using a NCR bronchoscopy skill center; dexterity, speed, and accuracy were tested using the skill center and an inanimate airway model before and after 4 h of group instruction and 4 h of individual unsupervised practice.Results were compared to those of a control group of four skilled physicians who had performed at least 200 bronchoscopies during 2 years of training. Student's t tests were used to compare mean scores of study and control groups for the inanimate model and VR bronchoscopy simulator. Before-training and after-training test scores were compared using pained t tests. For comparisons between after-training novice and skilled physician scores, unpaired two-sample t tests were used. Results: Novices significantly improved their dexterity and accuracy in both models. They, missed fewer segments after training than before training, and had fewer contacts with the bronchial wall. There vans no statistically significant improvement in speed or total time spent not visualizing airway anatomy. After training, novice performance equaled or sw-passed that of the skilled physicians. Novices performed more thorough examinations and missed significantly fewer segments in both the inanimate and virtual simulation models.Conclusion: A short, focused course of instruction and unsupervised practice using a virtual bronchoscopy simulator enabled novice trainees to attain a level of manual and technical skill at performing diagnostic bronchoscopic inspection similar to those of colleagues with several years of experience. These skills were readily reproducible in a conventional inanimate airway-training model, suggesting they, would also be translatable to direct patient care.