Effects of Real Time Feedback on Novice's Laparoscopic Learning Curve
Por:
Salvador M.-A., Arturo M.-M., Fernando P.-E., Dalia Danely M.-G., Jorge R.-L., Roberto S.-M., José Rafael R.-B., Jesús T.-J.
Publicada:
1 ene 2024
Ahead of Print:
1 jul 2024
Resumen:
Objective: Analyze the learning curve of medical students when they are trained with a laparoscopic box trainer and are presented with different modes of real-time feedback on their performance in the laparoscopic suturing procedure. Design: A prospective randomized controlled trial (RTC) was performed. Three groups were proposed: control, visual, and haptic. The block randomization technique was used to assign the participants to one of the three groups. Each group trained the intracorporeal square flat knot task in a standardized FLS box simulator. A total of 11 sessions were programmed for this study: a pre-training session, eight training sessions, a post-training session, and a follow-up session. Measurement of the generated reaction force during the task were taken weekly for the first 10 sessions (pre-training, training, and post-training); then, the follow-up measurement was taken a month after. Setting: This study was carried out in a single center at the Unidad de Simulación de Posgrado (USIP) of the postgraduate medicine program of the Universidad Nacional Autónoma de México (UNAM) between May and August 2023. Participants: The eligible participants were medical students without experience in minimally invasive surgery. All social service intern medics doing their social service in the USIP were invited to participate. A total of 20 participants entered the study from which 18 of them finished all the programmed sessions. Results: A total of ten metrics were extracted from the reaction force signal measured at each session. All metrics are directly proportional to the reaction force and low magnitudes imply high tissue-handling proficiency. All groups improved their tissue handling skills, being the visual group the one who achieved better performance, followed by the haptic group and lastly the control group. Conclusion: The use of real time feedback, especially visual feedback can help novices to shorten the learning process of tissue handling and achieve a better proficiency in advanced tasks in shorter training periods. © 2024 Association of Program Directors in Surgery
Filiaciones:
Salvador M.-A.:
Sección de Bioelectrónica, Departamento de Ingeniería Eléctrica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV–IPN), Ciudad de México, Mexico
Arturo M.-M.:
Sección de Bioelectrónica, Departamento de Ingeniería Eléctrica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV–IPN), Ciudad de México, Mexico
Fernando P.-E.:
Instituto de Ciencias Aplicadas y Tecnología (ICAT), Universidad Nacional Autónoma de México (UNAM), Circuito Exterior S/N, Ciudad Universitaria, Ciudad de México, Mexico
Dalia Danely M.-G.:
Sección de Bioelectrónica, Departamento de Ingeniería Eléctrica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV–IPN), Ciudad de México, Mexico
Jorge R.-L.:
Hospital Ángeles Pedregal, Ciudad de México, Mexico
Roberto S.-M.:
Hospital Ángeles Pedregal, Ciudad de México, Mexico
Unidad de Simulación de Posgrado, División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
José Rafael R.-B.:
Unidad de Simulación de Posgrado, División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
Jesús T.-J.:
Unidad de Simulación de Posgrado, División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
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