Randomized controlled trial of virtual reality simulator training: transfer to live patients

Area of Science:

• Medical Simulation
• Surgical Education
• Gastroenterology

Background:

• New general surgery residency requirements mandate 50 colonoscopies per resident.
• Computer-based simulators are proposed as a method to enhance resident preparedness for clinical procedures.
• This study evaluates the effectiveness of a colonoscopy simulator for skill transfer to live patient scenarios.

Purpose of the Study:

• To assess the effectiveness of a computer-based colonoscopy simulator in transferring skills to live patient procedures.
• To determine if simulator training improves resident performance in clinical colonoscopies.
• To evaluate the validity of simulator performance metrics against live patient outcomes.

Main Methods:

• A randomized controlled trial was conducted with general surgery and internal medicine residents.
• Participants with limited endoscopic experience were randomized into a simulator training group (n=12) or a control group (n=12).
• Technical skills were assessed by expert endoscopists using validated instruments after simulator training (or no additional training for controls) and a live colonoscopy.

Main Results:

• Residents who trained on the simulator achieved significantly higher global ratings during live colonoscopies compared to the control group (P = .04).
• Only two of the eight performance metrics from the computer-based simulator showed significant correlation with established global performance ratings.
• The study demonstrated a positive impact of simulator training on clinical performance.

Conclusions:

• Colonoscopy simulator training prior to initial patient procedures leads to significantly better clinical performance.
• The study provides evidence for the successful transfer of skills from a simulator to live patient colonoscopies.
• Further refinement of the simulator's performance metrics is needed due to limited concurrent validity.