MP23-13 MEDICAL STUDENT DELIBERATE PRACTICE ON A VIRTUAL-REALITY CURRICULUM CAN ACHIEVE EQUIVALENCY TO SENIOR UROLOGY RESIDENT REAL-TIME TRAINING

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment II1 Apr 2015MP23-13 MEDICAL STUDENT DELIBERATE PRACTICE ON A VIRTUAL-REALITY CURRICULUM CAN ACHIEVE EQUIVALENCY TO SENIOR UROLOGY RESIDENT REAL-TIME TRAINING Ahmed Ghazi, Aisha Siebert, Anees Fazili, Vineet Agrawal, Changyong feng, and Sarah Peyre Ahmed GhaziAhmed Ghazi More articles by this author , Aisha SiebertAisha Siebert More articles by this author , Anees FaziliAnees Fazili More articles by this author , Vineet AgrawalVineet Agrawal More articles by this author , Changyong fengChangyong feng More articles by this author , and Sarah PeyreSarah Peyre More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1256AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robotic virtual reality (VR) trainers have become an integral part of most urology programs. However, most surgical training programs struggle to incorporate them into their residency curricula. Several trials have demonstrated it is not the simulator that provides the learning, but rather it is the type of practice on the simulator that results in effective technical skills acquisition. Factors common to effective simulation training include; feedback, repetitive practice and task variation with clearly defined goals, the foundation of what has been termed deliberate practice. There has been little work to systematically investigate the effectiveness of deliberate practice within urological training. We hypothesized that novice trainees who engaged in a VR, deliberate practice, partial-task curriculum would demonstrate technical ability similar to residents with conventional informal teaching and feedback in the operating room. METHODS 13 medical students without any prior urologic experience completed a VR curriculum designed for vesicourethral anastomosis (VUA). This included: thread the rings, needle targeting, suture sponge, tubes, continuous suturing and knot tying exercises on the daVinci surgical skills simulator. Students trained to proficiency (90% overall score without critical errors) with expert feedback. At the end of training, each student was filmed completing a VUA on a dry-lab physical model (3-Dmed Franklin, Ohio) using the daVinci robot. 5 current and previous urology residents (PGY 4-6) with hands on radical prostatectomy training were filmed performing a similar anastomosis. 3 skilled urologists graded films in a blinded fashion using a modified Objective Structured Assessment of Technical Skill scale (range 1-30). RESULTS The median combined final score for medical students was 25.7 (IQR, 6.5-19.5), compared with 26 (IQR, 6.4-19.3) for residents (P=0.57). For each individual grader, there was no difference in median final scores between both groups (table 1). CONCLUSIONS Deliberate, individualized practice on a VR simulator improves technical performance similar to real-time training. This has implications to greatly improve the future of implementing simulation-based curricula in residency training programs. Modified OSATS† Medical students Deliberate Practice (Mean score) Residents hands-on operative training (Mean score) P-value Needle positioning 3.8 4.2 Needle entry 4.6 4.2 Tissue trauma 3.9 4 Suture alignment 4.2 4.2 Tissue approximation 4.5 5 Knot tying 4.6 4.4 Total score 25.6 26 0.57 † OSATS: Objective Structured Assessment of Technical Skill scale © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e272 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Ghazi More articles by this author Aisha Siebert More articles by this author Anees Fazili More articles by this author Vineet Agrawal More articles by this author Changyong feng More articles by this author Sarah Peyre More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...