Acquisition Of Psychomotor Skills Research Articles

Point-of-Care Ultrasound Psychomotor Learning Curves: A Systematic Review of the Literature.

Use of point-of-care ultrasound (POCUS) in clinical medicine and inclusion in medical training is increasing. Some professional societies recommend that 25-50 POCUS examinations be completed for each application learned; however, the amount of practice required is not well studied. As such, a better understanding of the learning curves of POCUS psychomotor skills is needed. This systematic review characterizes the learning curves for POCUS psychomotor skill acquisition. With the assistance of a research librarian, the available literature through August 28, 2023, was identified. The titles and abstracts, and then the full text were reviewed by two reviewers to screen for inclusion. All studies included after full-text review then underwent data extraction and analysis. The search identified 893 unique studies. Forty-five studies underwent full-text review, with 17 meeting full inclusion criteria. Substantial heterogeneity was noted in study design, duration of education, number and type of learners, and methods for statistical analysis. Clear and validated definitions for learning endpoints, such as plateau points or competency, are lacking. Learning curves and endpoints differ for different applications of POCUS. The results are overall supportive of the recommendations to complete 25-50 examinations per application of POCUS learned. However, specific applications require more practice than others. Certain applications, such as cardiac and the Focused Assessment with Sonography in Trauma (FAST) exams, are closer to 50; while others, such as soft tissue, airway, and eye require no more than 25.

Undergraduates' comparative assessment, utilizing a structured rubric, of hands-on versus video-supported presentation in class II cavity preparation.

Dental education is considered as a complex, challenging and often stressful educational procedure. Acquisition of psychomotor skills by undergraduate students is an important step in many health professions to become a successful professional. During under graduation, class II cavity preparation exercise is of utmost important in dentistry. To compare class II cavities prepared by students after hands-on live demonstration and pre-recorded video demonstration using well-organised evaluation rubrics. Preclinical dental students (n= 50) were divided into two groups. The students in group I (n= 25) attended a hands-on live demonstration performed by one faculty while students in group II (n= 25) watched a 15-minute pre-recorded procedural video on the projector. Both groups were appealed to prepare class II cavity for amalgam involving disto-occlusal surface of mandibular second molar articulated on jaw model (TRU LON study model, Jayna industries, Ghaziabad U.P., India). Following completion of the preparations, all teeth were collected, and labelled grades of prepared cavities were given according to prespecified rubrics. The data of scores were presented as means and standard deviation. Statistical analysis of data was executed using SPSS software. A paired t-test was used to compare scores between groups. The study shows that the video-supported demonstration of a cavity preparation was better than the live hands-on demonstration. A higher mean response for the procedural video group was found compared to the live demonstration group (p= 0.000133). Pre-recorded video-supported demonstration along with guidance by a tutor may be a viable alternative to hands-on live demonstration in cavity preparation procedures during undergraduate dental training. Moreover, rubric methods can be implemented in the teaching of various preclinical exercises for conservative dentistry and endodontics.

The exploration of remote simulation strategies for the acquisition of psychomotor skills in medicine: a pilot randomized controlled trial

BackgroundProgress in remote educational strategies was fueled by the advent of the COVID-19 pandemic. This pilot RCT explored the efficacy of a decentralized model of simulation based on principles of observational and peer-to-peer learning for the acquisition of surgical skills.MethodsSixty medical students from the University of Montreal learned the running subcuticular suture in four different conditions: (1) Control group (2) Self-learning (3) Peer-learning (4) Peer-learning with expert feedback. The control group learned with error-free videos, while the others, through videos illustrating strategic sub-optimal performances to be identified and discussed by students. Performance on a simulator at the end of the learning period, was assessed by an expert using a global rating scale (GRS) and checklist (CL).ResultsStudents engaging in peer-to-peer learning strategies outperformed students who learned alone. The presence of an expert, and passive vs active observational learning strategies did not impact performance.ConclusionThis study supports the efficacy of a remote learning strategy and demonstrates how collaborative discourse optimizes the students’ acquisition of surgical skills. These remote simulation strategies create the potential for implantation in future medical curriculum design.Trial Registration: NCT04425499 2020-05-06.

Learning curves for point-of-care ultrasound image acquisition for novice learners in a longitudinal curriculum

BackgroundA learning curve is graphical representation of the relationship between effort, such as repetitive practice or time spent, and the resultant learning based on specific outcomes. Group learning curves provide information for designing educational interventions or assessments. Little is known regarding the learning curves for Point-of-Care Ultrasound (POCUS) psychomotor skill acquisition of novice learners. As POCUS inclusion in education increases, a more thorough understanding of this topic is needed to allow educators to make informed decisions regarding curriculum design. The purpose of this research study is to: (A) define the psychomotor skill acquisition learning curves of novice Physician Assistant students, and (B) analyze the learning curves for the individual image quality components of depth, gain and tomographic axis.ResultsA total of 2695 examinations were completed and reviewed. On group-level learning curves, plateau points were noted to be similar for abdominal, lung, and renal systems around 17 examinations. Bladder scores were consistently good across all exam components from the start of the curriculum. For cardiac exams, students improved even after 25 exams. Learning curves for tomographic axis (angle of intersection of the ultrasound with the structure of interest) were longer than those for depth and gain. Learning curves for axis were longer than those for depth and gain.ConclusionBladder POCUS skills can be rapidly acquired and have the shortest learning curve. Abdominal aorta, kidney, and lung POCUS have similar learning curves, while cardiac POCUS has the longest learning curve. Analysis of learning curves for depth, axis, and gain demonstrates that axis has the longest learner curve of the three components of image quality. This finding has previously not been reported and provides a more nuanced understanding of psychomotor skill learning for novices. Learners might benefit from educators paying particular attention to optimizing the unique tomographic axis for each organ system.

Impact of the COVID-19 Pandemic on Learning: Assessing Cognitive, Affective, and Psychomotor Skills

The acquisition of cognitive, affective, and psychomotor skills is highly important for successful learning outcomes. This article aims to evaluate the Three-Domain Model (TDM) of learning (cognitive, affective, and psychomotor) during the COVID-19 online classes for tertiary students in Bangladesh. This current study aims at the psychometric evaluation and validation of tertiary students' learning loss during the pandemic. A survey questionnaire is administered using the Likert scale. The components of the questionnaire are based on the Three-Domain Model reflecting the cognitive, affective, and psychomotor skills of the students. The article informs of the learning loss due to the pandemic while suggesting the benefits of online classes. The major finding of the article is that learners lost their skills mainly related to the cognitive domain during the pandemic due to online classes. However, at the same time, their skills related to affective and psychomotor domains increased. Therefore, recommendations for minimizing learning loss are also provided to guide future empirical work in the post-pandemic era.

Towards best practice in developing motor skills: a systematic review on spacing in VR simulator-based psychomotor training for surgical novices

ObjectiveRepeated practice, or spacing, can improve various types of skill acquisition. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in fostering surgical skill acquisition and provide a promising, realistic environment for spaced training. To explore how spacing impacts VR simulator-based acquisition of surgical psychomotor skills, we performed a systematic literature review.MethodsWe systematically searched the databases PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, ERIC and CINAHL for studies investigating the influence of spacing on the effectiveness of VR simulator training focused on psychomotor skill acquisition in healthcare professionals. We assessed the quality of all included studies using the Medical Education Research Study Quality Instrument (MERSQI) and the risk of bias using the Cochrane Collaboration’s risk of bias assessment tool. We extracted and aggregated qualitative data regarding spacing interval, psychomotor task performance and several other performance metrics.ResultsThe searches yielded 1662 unique publications. After screening the titles and abstracts, 53 publications were retained for full text screening and 7 met the inclusion criteria. Spaced training resulted in better performance scores and faster skill acquisition when compared to control groups with a single day (massed) training session. Spacing across consecutive days seemed more effective than shorter or longer spacing intervals. However, the included studies were too heterogeneous in terms of spacing interval, obtained performance metrics and psychomotor skills analysed to allow for a meta-analysis to substantiate our outcomes.ConclusionSpacing in VR simulator-based surgical training improved skill acquisition when compared to massed training. The overall number and quality of available studies were only moderate, limiting the validity and generalizability of our findings.

Blended learning and simulation in nursing education: A quasi-experimental study on a nursing institute.

The nursing module teaches basic nursing principles and procedures to undergraduate nursing students. This course is important for the acquisition of procedural and psychomotor skills. The aim of the present study is to evaluate the influence of blended training on the acquisition of practical skills related to gastric insertion tubes. A quasi-experimental study was undertaken, containing three groups: The blended group benefited from e-learning, followed by simulation), while the two groups benefited from theoretical teaching and procedural simulation. Then, the degrees of acquisition of declarative and procedural knowledge and the time of completion were measured. The declarative knowledge grade was higher in the Simulation (16.07) and Blended (15.21) groups than in the Traditional Group (11.66), with a statistically significant difference (P < 0.001). The results also showed a statistically significant difference between the procedural knowledge grades of the three groups (P < 0.001). A statistically significant correlation was detected between declarative and procedural knowledge scores (r = 0.58, P < 0.001) and a negative correlation between procedural knowledge and the time of completion (r = -0.422, P < 0.001). The results of this experimentation confirm the positive effect of the blended learning approach on the acquisition of declarative and procedural knowledge as well as the time management allocated to teaching.

Low-cost Colonoscopic Simulator and Colonoscope to Train Basic Skills in Colonoscopy during Undergraduate Studies

Abstract Objective To develop a low-cost simulator model and a colonoscope with materials that are easily accessible to offer training on colonoscopy skills during undergraduate studies. Since this is the procedure of choice for colorectal cancer screening, the general practitioner must be able to recognize its main indications, preparation, and complications. Methods Using materials such as a mannequin, a vehicle inspection camera, a conduit, polyvinyl chloride (PVC) pipe, acrylic, wood, and red paint, we built a simulator and a 150-cm long and 20-to-25-mm thick colonoscope. The colonoscope's handle and handhold were made of acrylic, the colonoscope's mobile end was made with articulated PVC rings, and the up and down movements were performed according to the traction of the steel cables. The camera attached to its distal end enables connection to a smartphone to view the image. In the simulator, the conduit was inserted into the mannequin to simulate the curvatures of the colon. Red spray paint was used to simulate the staining of the colonic mucosa in the inner region of the mannequin and the adventitial layer in the outer region. Results We were able to build a simulator and a colonoscope with a total amount of R$ 182.82 (roughly US$ 36.50). Both were tested and proved to be useful in the acquisition of psychomotor and cognitive skills in colonoscopy. Conclusion The simulator and colonoscope developed by us are cost-effective, useful in the acquisition of psychomotor and cognitive skills in colonoscopy, and can facilitate the structuring of a training program for undergraduate students.

Cognitive changes with psychomotor skill acquisition through blended learning among nursing students: A qualitative study

AimThis study described nursing students’ cognitive changes as they acquire psychomotor skills through blended learning. BackgroundDeliberate practice, including feedback from teachers, is vital for acquiring psychomotor skills. Blended learning, a program that allows students to deepen their learning and improve their skills even when students and faculty are physically separated has attracted significant attention in recent years. Although blended learning has been used for learning in the cognitive domain, no study has examined its effectiveness in the acquisition of psychomotor skills. Understanding how students’ cognition changes as they acquire skills in a blended learning environment could be a valuable resource for effective teaching. DesignAn inductive, qualitative description approach was adopted. MethodsThe program involved a basic nursing skill: making an occupied bed. Eleven second-year nursing students participated. The participants attended face-to-face lectures and e-learning courses comprising self-study content that was designed for easy and frequent reference. Students practiced for a skill test, which was conducted one month after the first lecture. Two interviews were conducted approximately one month apart. Before each interview, the participants’ current practices were videotaped. During the interviews, they explained their thought processes and conscious awareness of their actions as they watched the videos. This study was conducted between April and May 2019. ResultsSix categories related to changes in participants’ cognitive processes while acquiring the skill of making an occupied bed were identified: “feeling that it is easy to acquire,” “practicing without much thought,” “realizing the difficulty in translating thoughts into practice,” “experiencing a sense of purpose in each technique,” “gaining a perspective to evaluate one’s skills,” and “developing one’s unique approach.” ConclusionsIn a blended learning environment, where a practice environment and audiovisual materials were provided, students could practice and improve their skills at their own pace even without the instructor’s frequent advice. The findings show that metacognitive skills are essential to the development of psychomotor skills in a blended learning program because this program requires practicing while monitoring one’s skills. Metacognitive skills affect the development of psychomotor skills and the ability to provide care. Therefore, initiatives that address the development of metacognitive skills, such as the current program, during the early stages of basic education programs can contribute to the development of nursing students’ practical skills.

The Learning Effects of Flipped Classroom Model on Nursing Student’s Vital Signs Skills: A Quasi-Experimental Study

Aim: The aim of the study is evaluated to the effect of the education with the flipped classroom class learning model in nursing psychomotor and cognitive and skillsMethod: A quasi experimental design was used with intervention (n=40) and comparison group (n=40), pre-test-post-test measures in the study. The experimental group (n=40) received a flipped classroom learning approach along with vital sings modules with learning and practicing the required, whereas the control group (n=40) received traditional classroom instruction. A knowledge test and a skills checklist were used to assess student performance.Results: The highest scores in post-test knowledge exam and skills exams were received by students who experienced flipped classroom education group (X̄=62.15±16.55; X̄=45.25±14.77, respectively). In addition, when the psychomotor skill test post-test total scores between the groups were examined, it was found that the experimental group had higher scores than the control group (X̄=38.92±0.85, X̄=30.79±1.41 respectively).Conclusion: The utilization of the flipped class model in nursing education was found to positively affect both theoretical knowledge and psychomotor skill acquisition.

Genotype-Phenotype Correlations in Neurofibromatosis Type 1: Identification of Novel and Recurrent NF1 Gene Variants and Correlations with Neurocognitive Phenotype.

Neurofibromatosis type 1 (NF1) is one of the most common genetic tumor predisposition syndrome, caused by mutations in the NF1. To date, few genotype-phenotype correlations have been discerned in NF1, due to a highly variable clinical presentation. We aimed to study the molecular spectrum of NF1 and genotype-phenotype correlations in a monocentric study cohort of 85 NF1 patients (20 relatives, 65 sporadic cases). Clinical data were collected at the time of the mutation analysis and reviewed for accuracy in this investigation. An internal phenotypic categorization was applied. The 94% of the patients enrolled showed a severe phenotype with at least one systemic complication and a wide range of associated malignancies. Spine deformities were the most common complications in this cohort. We also reported 66 different NF1 mutations, of which 7 are novel mutations. Correlation analysis identified a slight significant inverse correlation between age at diagnosis and delayed acquisition of psychomotor skills with residual multi-domain cognitive impairment. Odds ratio with 95% confidence interval showed a higher prevalence of learning disabilities in patients carrying frameshift mutations. Overall, our results aim to offer an interesting contribution to studies on the genotype–phenotype of NF1 and in genetic management and counselling.

Development of a Standardized Assessment of Simulation-based Extracorporeal Membrane Oxygenation Educational Courses.

BackgroundIn 2020, the Extracorporeal Life Support Organization education task force identified seven extracorporeal membrane oxygenation (ECMO) educational domains that would benefit from international collaborative efforts. These included research efforts to delineate the impact and outcomes of ECMO courses.ObjectiveDevelopment of a standardized online assessment tool to evaluate the effectiveness of didactic and simulation-based ECMO courses on participants’ confidence, knowledge, and simulation-based skills; participant satisfaction; and course educational benefits.MethodsWe performed a prospective multicenter observational study of five different U.S. academic institution–based adult ECMO courses that met Extracorporeal Life Support Organization endorsement requirements for course structure, educational content, and objectives. Standardized online forms were developed and administered before and after courses, assessing demographics, self-assessment regarding ECMO management, and knowledge examination (15 simple-recall multiple-choice questions). Psychomotor skill assessment was performed during the course (time to complete prespecified critical actions during simulation scenarios). Self-assessment evaluated cognitive, behavioral, and technical aspects of ECMO; course satisfaction; and educational benefits.ResultsOut of 211 participants, 107 completed both pre- and postcourse self-assessment forms (97 completed both pre- and postcourse knowledge forms). Fifty-three percent of respondents were physician intensivists, with most (51%) practicing at academic hospitals and with less than 1 year of ECMO experience (50%). After the course, participants reported significant increases in confidence across all domains (cognitive, technical, and behavioral, P < 0.0001, 95% confidence interval [CI], 1.2–1.5; P < 0.0001, 95% CI, 2.2–2.6; and P = 0.002, 95% CI, 1.7–2.1, respectively) with an increase in knowledge scores (P < 0.001; 95% CI, 1.4–2.5). These findings were most significant in participants with less ECMO experience. There were also significant reductions in times to critical actions in three of the four scored simulation scenarios. The results demonstrated participants’ satisfaction with most course aspects, with more than 95% expressing that courses met their educational goals.ConclusionWe developed and tested a structured ECMO course assessment tool, demonstrating participants’ self-reported benefit as well as improvement in psychomotor skill acquisition, course satisfaction, and educational benefits. Course evaluation is feasible and potentially provides important information to improve ECMO courses. Future steps could include national implementation, addition of questions targeting clinical decision making to further assess knowledge gain, and multilanguage translation for implementation in international courses.

Impact of the Haptic Virtual Reality Simulator on Dental Students' Psychomotor Skills in Preclinical Operative Dentistry.

One of the current trends in dental education is to empower dental students on a global platform using advanced technology. Haptic virtual reality simulation (HVRS) is a relatively new technology in the field of teaching and learning operative dentistry. This study aims to assess the impact of haptic virtual reality simulation (HVRS) on dental students’ psychomotor skills acquisition in preclinical operative dentistry. Class I cavity preparations (CP) were performed at baseline by 21 novice dental students on plastic teeth. Duration of CP was recorded and cavity features were evaluated and scored. Then, students were exposed to HVRS training on CP. Another Class I CP was performed by each student on plastic teeth after HVRS training, then evaluated, and the duration was recorded. There was a statistically significant decrease in CP performance time after HVRS training (p < 0.001) and an increase in the mean total marks of CP after HVRS training (p < 0.001). The change in the students’ performance in the CP displayed a statistically significant improvement after HVRS training in smoothness of the pulpal floor (p = 0.047), pulpal floor direction (p = 0.029), buccal, lingual, and mesial wall direction (p = 0.004, p = 0.025, p = 0.002), mesial and distal wall smoothness (p = 0.01, p = 0.001), internal line angle (p = 0.024), and internal point angle (p = 0.029). Overall improved performance in psychomotor skills was found after HVRS training. It could be beneficial to incorporate HVRS training early in pre-clinical operative dentistry courses as an adjunct to conventional phantom head training.

A novel scale to measure students' perceptions of exemplars in a dental school.

Exemplars are an effective strategy for initial cognitive and psychomotor skill acquisition and promoting students' self-regulation. Yet, there is limited evidence about students' use and perception of exemplars in dental education. Therefore, this study aimed to develop a scale to measure students' perception of exemplars in an Australian dental school. Phase I assessed the relevant literature and students' responses to an interview. Four themes were identified for developing a 19-item questionnaire rated by an expert panel. Phase II piloted the questionnaire amongst a group of 30students. Phase III analysed psychometric and qualitative open-ended questions data obtained from a large group of students. The principal axis factoring resulted in one single factor that explained over 62% of the variance and had an alpha of .88. The number of questions was reduced from 19 to 6 items with loadings of 0.72 or above for each item. Students reported exemplars are beneficial for their learning and to visually guide them to understand procedures and their intended outcomes. This prompts them to think and mentally prepare before performing. Students further reported using exemplars provided by their courses almost as often as exemplars they search in social media. Well-developed exemplars could play a key role in enhancing learning and could assist teaching. Understanding students' use and perception of exemplars will help educators to develop and evaluate appealing exemplars. Therefore, this study developed a new instrument to measure students' perception of exemplars, verified its reliability and validity.

Bullying in the clinical setting: Lived experiences of nursing students in the Central Region of Ghana.

IntroductionNursing students are confronted with bullies in the classroom and during clinical placement. Acquisition of the necessary psychomotor skills intended during clinical placements may be impeded when workplace bullies intimidate students. This study aimed to describe the various bullying behaviours experienced by nursing students and their effects during clinical placement in the Central Region of Ghana.MethodsA qualitative phenomenological descriptive approach using a semi-structured interview guide was employed to collect data from nursing students in focus groups. Overall, six (6) focus groups were used, with five (5) students in each group comprising males and females. The sample size was based on data saturation and was saturated on the six focus group discussions giving a sample size of 30. Purposive sampling was used to select students who had been on the ward at least three clinical placements and had experienced bullying in the clinical setting. In-depth interviews were conducted, recorded, transcribed verbatim and analysed using content analysis.ResultsThe study revealed that nursing students had experienced bullying practices such as shouting, isolation, humiliation and being assigned tasks below their competency level. In addition, findings showed that bullying led to a loss of confidence and caused stress and anxiety in nursing students.ConclusionTherefore, it is recommended that nursing students are mentored holistically in a caring and accepting environment where they will be supported to achieve their learning goals, build their confidence, and develop their personal and professional identity.

A review of simulation training and new 3D computer-generated synthetic organs for robotic surgery education

We conducted a comprehensive review of surgical simulation models used in robotic surgery education. We present an assessment of the validity and cost-effectiveness of virtual and augmented reality simulation, animal, cadaver and synthetic organ models. Face, content, construct, concurrent and predictive validity criteria were applied to each simulation model. There are six major commercial simulation machines available for robot-assisted surgery. The validity of virtual reality (VR) simulation curricula for psychomotor assessment and skill acquisition for the early phase of robotic surgery training has been demonstrated. The widespread adoption of VR simulation has been limited by the high cost of these machines. Live animal and cadavers have been the accepted standard for robotic surgical simulation since it began in the early 2000s. Our review found that there is a lack of evidence in the literature to support the use of animal and cadaver for robotic surgery training. The effectiveness of these models as a training tool is limited by logistical, ethical, financial and infection control issues. The latest evolution in synthetic organ model training for robotic surgery has been driven by new 3D-printing technology. Validated and cost-effective high-fidelity procedural models exist for robotic surgery training in urology. The development of synthetic models for the other specialties is not as mature. Expansion into multiple surgical disciplines and the widespread adoption of synthetic organ models for robotic simulation training will require the ability to engineer scalability for mass production. This would enable a transition in robotic surgical education where digital and synthetic organ models could be used in place of live animals and cadaver training to achieve robotic surgery competency.

Innovative approaches to teaching vascular access to nursing students in the COVID-19 era.

For the student nurse, peripheral venous cannulation is one of the most stressful skills to be learned. Although some healthcare employers/establishments offer courses on vascular access and infusion nursing as part of their onboarding programs, ultimately educational institutions should share the responsibility to ensure that graduating nurses can provide safe infusion therapies. An innovative vascular access and infusion nursing (VAIN) curriculum was created and mapped onto the entry to practice undergraduate nursing program at McGill University in Montréal, Québec, Canada. This presented an opportunity to implement new teaching approaches. Students experienced multiple new teaching approaches including multimedia and experiential learning and live simulation to ensure acquisition of knowledge and psychomotor skills. The teaching approaches had to be rapidly modified with the advent of the COVID-19 pandemic. The VAIN curriculum emphasizes simulation and directed practice, seeking to increase competence, confidence, and knowledge. The pandemic underscored the need for flexibility and creativity in content delivery.

The application of reusable learning objects (RLOs) in preparation for a simulation laboratory in medication management: An evaluative study

To enhance the preparedness of undergraduate nursing and midwifery students to participate in the safe provision of medication administration on their clinical placements, an innovative blended learning strategy was designed and developed by the authors. The blended learning strategy included a suite of online reusable learning objects specific to medication management theoretical knowledge and psychomotor skills to prepare students for a 90-minute practical face to face simulation laboratory session. Students identified that the reusable learning objects had prepared them for the simulation laboratory session and was rated as a productive learning experience. The blended learning strategy implemented to teaching and learning medication management to undergraduate nursing and midwifery students can positively influence students’ acquisition of knowledge and psychomotor skills to safely administer medications prior to their practice placements in a clinical setting.

Innovative approaches to teaching vascular access to nursing students in the COVID-19 era

Purpose: For the student nurse, peripheral venous cannulation is one of the most stressful skills to be learned. Although some healthcare employers/establishments offer courses on vascular access and infusion nursing as part of their onboarding programs, ultimately educational institutions should share the responsibility to ensure that graduating nurses can provide safe infusion therapies. Methods: An innovative vascular access and infusion nursing (VAIN) curriculum was created and mapped onto the entry-to-practice undergraduate nursing program at McGill University in Montréal, Québec, Canada. This presented an opportunity to implement new teaching approaches. Results: Students experienced multiple new teaching approaches including multimedia and experiential learning and live simulation to ensure acquisition of knowledge and psychomotor skills. The teaching approaches had to be rapidly modified with the advent of the COVID-19 pandemic. Conclusions: The VAIN curriculum emphasizes simulation and directed practice, seeking to increase competence, confidence, and knowledge. The pandemic underscored the need for flexibility and creativity in content delivery.

Psychomotor skills development for Veress needle placement using a virtual reality and haptics-based simulator

PurposeVeress needle (VN) insertion, if not correctly performed, could cause severe injuries to intra-abdominal organs and vessels. Therefore, cognitive and psychomotor skills training is needed. Virtual reality (VR) and haptic technologies have the potential to offer realistic simulations.MethodsWe developed a novel VR and haptic surgical simulator for VN insertion to teach trainees how to correctly puncture the abdominal wall, experiencing realistic tactile sensations throughout the simulation. The simulator allows for both procedural and realistic training. We released two different versions: the first using the OpenHaptics^{text {TM}} (OH) Toolkit and the second exploiting CHAI3D. We evaluated the learning effect using different performance indexes (time to perform the procedure, error in insertion angle, number of undesired contacts with organs) in an insertion task for both experienced urologists and students.ResultsA general improvement of the chosen performance indexes was registered in the second repetition of the task for both groups. From the questionnaires, the simulator leveraging OH provides the trainee with a more precise haptic feedback, whereas the one exploiting CHAI3D allows them to perform the procedure more easily thanks to the better visualization of the virtual environment. The results proved that the participants appreciated both implementations, and the System Usability Scale (SUS) test resulted in a “good” usability.ConclusionThe haptics-based and VR simulator has shown the potential to be an important resource for the basic urological training in obtaining the pneumoperitoneum and improving the acquisition of the necessary psychomotor skills, allowing for extended and more effective training without compromising patient safety.