Multi-Institutional Predictive Validity Study of a Virtu

Virtu 的多机构预测有效性研究

• 批准号: 6930786
• 负责人: Robert Marten Sweet
• 金额: $ 4.95万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6930786
• 关键词: behavioral /social science research tag; computer assisted instruction; computer simulation; education evaluation /planning; health care personnel performance; health care quality; health care service evaluation; human data; medical education; patient oriented research; patient safety /medical error; prostate surgery; training aid

DESCRIPTION (PROVIDED BY APPLICANT): Background: Transurethral resection of the prostate (TURP) remains the gold-standard surgical treatment for medically refractory symptoms of benign prostatic hyperplasia (BPH), a condition that is symptomatic in approximately 5.6 million men in the United States alone. There is great concern in the Urological community that the training and assessment of the skills necessary to perform TURP may be inadequate. With an overall research mission statement to enhance proficiency and diminish operative errors through the design, development, validation and dissemination of novel training systems for medical procedures, the primary goal of this project is to examine predictive validity of a novel virtual reality TURP trainer built at the University of Washington. This simulator has already undergone preliminary validation studies. Direct evidence of translation of skills from the virtual world to the operating room is lacking and needs to occur prior to implementation of simulation technology into the residency curriculum. We hypothesize that practicing on this trainer will lead to diminished errors and increased proficiency among cohorts of surgeons in training (residents). Methods: 90 Urology residents in training from eight institutions will undergo evaluation at their home institution by the Global Surgical Assessment forms on four sequential TURP cases. These cases will also be video-taped, and the median bar component of the case will be assessed by three blinded subject matter experts. Intraoperative metrics contributing to "performance" will also be collected and consist of time to task, tissue resected, number of cuts, blood loss, irrigation use and errors performed. Between cases 2 and 3, half of the residents (randomized within groups sorted by institution and skill-level) will undergo intensive 2 day training on the UW TURP trainer to criterion-level. Similar metrics as taken from the OR will be collected from a full pre-training and post-training TURP on the simulator and correlated with intraoperative metrics. Improvements in performance and number of operative errors will be compared between those residents who trained on the simulator and those who did not.

描述（由申请人提供）： 背景：经尿道前列腺电切术 (TURP) 仍然是良性前列腺增生 (BPH) 医学难治性症状的金标准手术治疗方法，仅在美国就有约 560 万男性出现这种症状。泌尿外科界非常担心实施 TURP 所需技能的培训和评估可能不足。该项目的总体研究任务是通过设计、开发、验证和传播新型医疗程序培训系统来提高熟练程度并减少操作错误，其主要目标是检查华盛顿大学建造的新型虚拟现实 TURP 培训器的预测有效性。该模拟器已经进行了初步验证研究。缺乏将技能从虚拟世界转移到手术室的直接证据，需要在将模拟技术纳入住院医师课程之前进行。我们假设在该训练器上进行练习将减少错误并提高群体的熟练程度 接受培训的外科医生（住院医师）。 方法：来自八个机构的 90 名泌尿外科住院医师将在其所在机构接受全球外科评估表对四个连续 TURP 病例的评估。这些案件也将被录像，案件的中线部分将由三名盲法主题专家进行评估。有助于“表现”的术中指标也将被收集，包括完成任务的时间、切除的组织、切割次数、失血量、冲洗使用和执行的错误。在案例 2 和案例 3 之间，一半的住院医师（按机构和技能水平随机分组）将接受 UW TURP 培训师为期 2 天的强化培训，达到标准水平。与 OR 类似的指标将从模拟器上的完整预训练和训练后 TURP 中收集， 与术中指标相关。将比较那些在模拟器上接受过培训的住院医师和没有接受过培训的住院医师在性能和操作错误数量方面的改进。