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O020 Does real-time surgical training on auxiliary screens affect performance and cognitive demands during surgery? a randomised crossover study on VR-simulated laparoscopic cholecystectomies.
9 auth. J. Winter Beatty, S. Chidambaram, S. Erridge, PO Ortega, HS Sidhu, M. Souvatzi, ... M. Sodergren, J. Kinross, S. Purkayastha
Technological innovations are pivotal to surgical training. It is unclear however, if these technologies deployed intra-operatively affect surgeon performance or cognitive burdens. Ethical approval was gained from our institute. Forty-e…
Technological innovations are pivotal to surgical training. It is unclear however, if these technologies deployed intra-operatively affect surgeon performance or cognitive burdens. Ethical approval was gained from our institute. Forty-eight medical students, foundation, and core surgical doctors completed accredited eLearning on Laparoscopic cholecystectomy and basic laparoscopic skill modules on a VR-simulator. Operative workflows with step-by-step instructions to perform a level-1 laparoscopic cholecystectomy were prepared by expert surgeons. Participants were randomly allocated to complete the procedure with or without workflows, and then crossover twice, for a total of three cholecystectomies. After each simulation, participants completed a validated surgical task load index (SURG-TLX), measuring cognitive demands. After the study, they completed training evaluations. Screen-recordings of the procedures were blindly assessed by expert surgeons, using validated OSATS scores and procedure-specific performance and error scores (Eubanks et al, 1999). Statistical significance was defined with a p-value <0.05. Demographics did not differ significantly between groups. At the final attempt, OSATS were slightly improved, but not significantly, when using workflows (19 v. 17, p=0.9); as were performance scores (72 v. 71.5, p=0.73) and error scores (17 v. 22, p=0.268). Surg-TLX scores were also reduced although only significantly for Temporary-Demands (p=0.037). Procedure time was longer in the workflow group (20.5 v. 14 minutes, p=0.033). Above 90% of participants agreed workflows were enjoyable, user-friendly and aided learning. Real-time operative workflows are perceived as useful learning adjuncts and may diminish cognitive burdens. Further research is needed to confirm if workflows improve performance and diminish errors. In a VR simulated procedure, intra-operative surgical workflows do not seem to affect surgeon cognitive burden. OSATS, performance and error scores may be improved but further research is needed.
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0 2022