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Virtual Reality Simulation Has Weak Correlation with Overall Trainee Robot-Assisted Laparoscopic Hysterectomy
Alexandra J Berges1, S Swaroop Vedula2, Anand Malpani2
1Johns Hopkins University School of Medicine (Ms. Berges).
Journal of Minimally Invasive Gynecology
|December 13, 2021
Summary
Virtual reality simulation scores showed limited correlation with surgical trainee performance in robotic-assisted laparoscopic hysterectomy. Current assessment tools like GEARS struggle to differentiate skill levels, highlighting the need for improved evaluation methods in surgical training.
Area of Science:
- Surgical Education
- Medical Simulation
- Robotic Surgery
Background:
- Surgical trainee development relies on both simulator practice and intraoperative performance.
- The effectiveness of skill transfer from simulation to real-world surgical scenarios remains an area of active investigation.
- Robotic-assisted laparoscopic hysterectomy (RALH) is a complex procedure requiring specialized surgical skills.
Purpose of the Study:
- To evaluate the correlation between virtual reality (VR) simulation performance and intraoperative outcomes in gynecological trainees performing RALH.
- To assess the relationship between simulation scores and overall intraoperative performance.
- To specifically examine the link between simulation proficiency and performance during the vaginal cuff closure, a critical suturing step.
Main Methods:
- A retrospective subgroup analysis was conducted on data from a randomized controlled trial.
- Twenty-one gynecological trainees performed VR simulation tasks using the da Vinci skills simulator prior to RALH procedures.
- Intraoperative performance was assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) by attending surgeons, with specific focus on vaginal cuff closure via video analysis.
- Spearman's correlation was employed to analyze the relationship between simulation and intraoperative performance metrics.
Main Results:
- Trainees achieved a median intraoperative GEARS score of 18.5/30 and a median simulator score of 84.4/100.
- No significant correlation was found between overall simulation performance and intraoperative vaginal cuff closure scores.
- Simulation performance showed a negative correlation with GEARS Bimanual Dexterity and Force Sensitivity subscores, suggesting potential skill transfer limitations in these areas.
Conclusions:
- Limited correlation exists between virtual reality simulation performance metrics and overall intraoperative performance in robotic-assisted laparoscopic hysterectomy.
- Current Global Evaluative Assessment of Robotic Skills (GEARS) scores may not adequately differentiate between varying, yet similar, trainee skill levels.
- Development of more refined intraoperative assessment tools is necessary to accurately gauge and distinguish trainee proficiency.
