Multi-Institutional Predictive Validity Study of a Virtu

描述(申请人提供)：背景：经尿道前列腺电切术(TURP)仍然是治疗良性前列腺增生症(BPH)医学难治性症状的黄金标准外科治疗方法，仅在美国就有大约560万男性出现这种症状。尿道界非常担心，对实施TURP所需技能的培训和评估可能不够充分。通过设计、开发、验证和传播医疗程序的新型培训系统，该项目的主要目标是检查华盛顿大学建造的新型虚拟现实TURP训练器的预测有效性，总体研究任务是通过设计、开发、验证和传播提高熟练程度和减少操作错误。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化到手术室的直接证据，需要在将模拟技术应用到驻地培训课程之前进行。我们假设，在这个训练器上练习将减少错误，并提高队列中的熟练程度 正在接受培训的外科医生(住院医生)。 方法：对来自8个机构的90名正在接受培训的泌尿外科住院医师在其所在机构接受全球外科评估表格，对4个连续的TURP病例进行评估。这些案件还将被录像，案件的中位数栏部分将由三名盲人主题专家进行评估。还将收集影响手术“性能”的术中指标，包括完成任务的时间、切除的组织、切割次数、失血量、冲洗使用和操作错误。在病例2和病例3之间，一半的住院医生(按机构和技能水平随机分组)将在UW TURP培训器上接受为期2天的强化培训，达到标准水平。来自OR的类似指标将从模拟器上的完整培训前和培训后TURP中收集，并 与术中指标相关。对那些在模拟器上接受培训的住院医生和那些没有接受培训的住院医生在性能和操作错误数量方面的改善进行比较。

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.