The development of laparoscopic skills using virtual reality simulations: A systematic review.
Ontology highlight
ABSTRACT: Background
Teaching based on virtual reality simulators in medicine has expanded in recent years due to the limitations of more traditional methods, especially for surgical procedures such as laparoscopy.Purpose of review
To analyze the effects of using virtual reality simulations on the development of laparoscopic skills in medical students and physicians.Data sources
The literature screening was done in April 2020 through Medline (PubMed), EMBASE and Database of the National Institute of Health.Eligibility criteria
Randomized clinical trials that subjected medical students and physicians to training in laparoscopic skills in virtual reality simulators.Study appraisal
Paired reviewers independently identified 1529 articles and included 7 trials that met the eligibility criteria.Findings
In all studies, participants that trained in virtual simulators showed improvements in laparoscopic skills, although the articles that also had a physical model training group did not show better performance of one model compared to the other.Limitations
No article beyond 2015 met the eligibility criteria, and the analyzed simulators have different versions and models, which might impact the results.Conclusion
Virtual reality simulators are useful educational tools, but do not show proven significant advantages over traditional models. The lack of standardization and a scarcity of articles makes comparative analysis between simulators difficult, requiring more research in the area, according to the model suggested in this review.Systematic review registration number
Registered by the Prospective Register of Systematic Reviews (PROSPERO), identification code CRD42020176479.
SUBMITTER: Taba JV
PROVIDER: S-EPMC8211221 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BACKGROUND: Virtual reality (VR) is an emerging new modality for laparoscopic skills training; however, most simulators lack realistic haptic feedback. Augmented reality (AR) is a new laparoscopic simulation system offering a combination of physical objects and VR simulation. Laparoscopic instruments are used within an hybrid mannequin on tissue or objects while using video tracking. This study was designed to assess the difference in realism, haptic feedback, and didactic value between AR and VR laparoscopic simulation. METHODS: The ProMIS AR and LapSim VR simulators were used in this study. The participants performed a basic skills task and a suturing task on both simulators, after which they filled out a questionnaire about their demographics and their opinion of both simulators scored on a 5-point Likert scale. The participants were allotted to 3 groups depending on their experience: experts, intermediates and novices. Significant differences were calculated with the paired t-test. RESULTS: There was general consensus in all groups that the ProMIS AR laparoscopic simulator is more realistic than the LapSim VR laparoscopic simulator in both the basic skills task (mean 4.22 resp. 2.18, P < 0.000) as well as the suturing task (mean 4.15 resp. 1.85, P < 0.000). The ProMIS is regarded as having better haptic feedback (mean 3.92 resp. 1.92, P < 0.000) and as being more useful for training surgical residents (mean 4.51 resp. 2.94, P < 0.000). CONCLUSIONS: In comparison with the VR simulator, the AR laparoscopic simulator was regarded by all participants as a better simulator for laparoscopic skills training on all tested features.
| S-EPMC1913183 | biostudies-other
Project description:BackgroundPedestrian injuries are among the leading causes of morbidity and mortality in middle childhood. One limitation to existing pedestrian safety interventions is that they do not provide children with repeated practice needed to develop the complex perceptual and cognitive skills required for safe street crossing. Virtual reality offers training through repeated unsupervised practice without risk, automated feedback on success of crossings, adjustment of traffic to match children's skill and a fun, appealing environment for training.ObjectiveTo test the efficacy of virtual reality to train child pedestrians in safe street crossing.SettingBirmingham, Alabama, USA.MethodsA randomised controlled trial is underway with an expected sample of four groups of 60 children aged 7-8 years (total N=240). One group receives training in an interactive, immersive virtual pedestrian environment. A second receives pedestrian safety training via widely used video and computer strategies. The third group receives what is judged to be the most efficacious treatment currently available, individualised behavioural training at streetside locations. The fourth group serves as a no-contact control group. All participants are exposed to a range of field and laboratory-based measures of pedestrian skill during baseline and post-intervention visits, as well as during a 6-month follow-up assessment.Outcome measuresPrimary analyses will be conducted through linear mixed models testing change over time in the four intervention groups. Three pedestrian safety measures will serve as primary outcomes: temporal gap before initiating crossing, temporal gap remaining after crossing and attention to traffic while waiting to cross.
| S-EPMC2829738 | biostudies-literature
Project description:Virtual reality simulation (VRS) allows individuals to experience a sense of presence in a virtual environment, and it has been increasingly adopted as a novel teaching method in nursing education. VRS can have positive effects, such as patient safety, privacy assurance in healthcare, and enhanced interest and immersion in education. It is important to synthesize the results to date to determine if VRS has the potential to improve communication skills in practical nursing students. This systematic literature review and meta-analysis investigated the effect of VRS on the enhancement of communication skills among nursing students. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were employed for systematic review and meta-analysis. The following "PICO" details were considered: population-nursing students, intervention-VRS targeting communication skills enhancement, comparator-control groups without intervention or those undergoing general classes, and outcomes-communication skills. The search strategy yielded 301 results from nine databases, and 10 studies were selected for inclusion in our analysis. To calculate the overall effect sizes of the primary and secondary outcomes in the included studies, we used MIX 2.0 Pro (Version 2.0.1.6, BiostatXL, 2017) for the meta-analysis. The overall effect size for communication skills was 0.44, signifying a significant effect. A meta-regression analysis examining communication skills revealed significant results for the following factors: Fund (Ref.: No), outcome measurement time (Ref.: Immediately), outcome follow-up (Ref.: No), and debriefing (Ref.: No). Considering factors such as variations in sample size, research approaches, and the effects of independent studies on communication skills, this systematic literature review and meta-analysis suggests that VRS significantly improves nursing students' communication skills overall.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42023439064.
| S-EPMC11258010 | biostudies-literature
Project description:IntroductionVirtual reality (VR) and augmented reality (AR) technologies are increasingly being used in undergraduate medical education. We aim to evaluate the effectiveness of VR and AR technologies for improving knowledge and skills in medical students.Methods and analysisUsing Best Evidence in Medical Education (BEME) collaboration guidelines, we will search MEDLINE (via PubMed), Education Resources Information Center, PsycINFO, Web of Knowledge, Embase and the Cochrane Central Register of Controlled Trials for English-language records, from January 1990 to March 2021. Randomised trials that studied the use of VR or AR devices for teaching medical students will be included. Studies that assessed other healthcare professionals, or did not have a comparator group, will be excluded. The primary outcome measures relate to medical students' knowledge and clinical skills. Two reviewers will independently screen studies and assess eligibility based on our prespecified eligibility criteria, and then extract data from each eligible study using a modified BEME coding form. Any disagreements will be resolved by discussion or, if necessary, the involvement of a third reviewer. The BEME Quality Indicators checklist and the Cochrane Risk of Bias Tool will be used to assess the quality of the body of evidence. Where data are of sufficient homogeneity, a meta-analysis using a random-effects model will be conducted. Otherwise, a narrative synthesis approach will be taken and studies will be evaluated based on Kirkpatrick's levels of educational outcomes and the Synthesis Without Meta-analysis guidelines.Ethics and disseminationEthical approval is not required for this systematic review as no primary data are being collected. We will disseminate the findings of this review through scientific conferences and through publication in a peer-reviewed journal.
| S-EPMC8370502 | biostudies-literature
Project description:BackgroundMany junior doctors must prepare to manage acutely ill patients in the emergency department. The setting is often stressful, and urgent treatment decisions are needed. Overlooking symptoms and making wrong choices may lead to substantial patient morbidity or death, and it is essential to ensure that junior doctors are competent. Virtual reality (VR) software can provide standardized and unbiased assessment, but solid validity evidence is necessary before implementation.ObjectiveThis study aimed to gather validity evidence for using 360-degree VR videos with integrated multiple-choice questions (MCQs) to assess emergency medicine skills.MethodsFive full-scale emergency medicine scenarios were recorded with a 360-degree video camera, and MCQs were integrated into the scenarios to be played in a head-mounted display. We invited 3 groups of medical students with different experience levels to participate: first- to third-year medical students (novice group), last-year medical students without emergency medicine training (intermediate group), and last-year medical students with completed emergency medicine training (experienced group). Each participant's total test score was calculated based on the number of correct MCQ answers (maximum score of 28), and the groups' mean scores were compared. The participants rated their experienced presence in emergency scenarios using the Igroup Presence Questionnaire (IPQ) and their cognitive workload with the National Aeronautics and Space Administration Task Load Index (NASA-TLX).ResultsWe included 61 medical students from December 2020 to December 2021. The experienced group had significantly higher mean scores than the intermediate group (23 vs 20; P=.04), and the intermediate group had significantly higher scores than the novice group (20 vs 14; P<.001). The contrasting groups' standard-setting method established a pass-or-fail score of 19 points (68% of the maximum possible score of 28). Interscenario reliability was high, with a Cronbach α of 0.82. The participants experienced the VR scenarios with a high degree of presence with an IPQ score of 5.83 (on a scale from 1-7), and the task was shown to be mentally demanding with a NASA-TLX score of 13.30 (on a scale from 1-21).ConclusionsThis study provides validity evidence to support using 360-degree VR scenarios to assess emergency medicine skills. The students evaluated the VR experience as mentally demanding with a high degree of presence, suggesting that VR is a promising new technology for emergency medicine skills assessment.
| S-EPMC10282911 | biostudies-literature
Project description:BackgroundInnovations in virtual reality (VR) technologies have improved the adaptability of its use in therapeutic settings, and VR has shown to be a promising treatment for fear of medical procedures, with research increasing in this area in recent years.PurposeThis review aims to collate evidence for the impact of VR on fear of medical procedures.MethodsCENTRAL (Cochrane), MEDLINE, EMBASE, and PsychINFO databases were searched up to October 2020. A mix of experimental and case-control studies were included for review, which evaluated the effectiveness of VR for fear, anxiety, and pain of medical procedures for people with needle phobia, dental phobia, claustrophobia of medical scans, and burn wound care anxiety. Risk of bias (RoB) was assessed by Cochrane and ROBINS-I tools.ResultsTwenty-eight studies were selected. Some studies included mixed participant groups of young people adults. The interventions varied, with VR used for distraction, hypnosis, or exposure. These were shown to be effective for reducing fear of medical procedures. However, effectiveness for blood-injection-injury phobias and burn wound care patients was unclear.ConclusionsEvidence on the effectiveness of VR suggests that it does decrease fear of medical procedures in some situations. However, the RoB assessment illustrated a poor quality of studies across those included in this review, limiting the ability to draw firm general conclusions from the study findings. There is a need for further research exploring the use of VR technologies in the management of anxiety in physical health care settings.
| S-EPMC8557375 | biostudies-literature
Project description:In the forensic field, most studies employing virtual reality (VR) interventions have focused on offenders. The validity and safety of VR applications for victims of crime are still unclear. Following PRISMA guidelines, a systematic review on VR interventions for crime victims was performed to assess the efficacy, acceptability by patients, and cost-effectiveness of these interventions compared to in-person care. We identified 34 potentially eligible studies from 188 records obtained from database searches (Medline/Pubmed, CINAHL, PsycINFO, Web of Science, and Scopus); four additional articles were identified via alternative sources. In total, nine articles were included for the qualitative synthesis. Patient satisfaction with VR interventions was found to be equivalent to face-to-face interventions. Both VR exposure and control groups found relief from posttraumatic symptoms, with differences either statistically insignificant or in favor of VR. Despite the increased costs linked to the technology required, VR appears to be a promising alternative to in vivo exposure, but further research is needed. Limitations of the review include the varied experimental protocols, which did not allow us to conduct a quantitative analysis and comparison of findings across different studies, and the generally poor quality of the studies included. Further research, preferably in larger groups, is needed to shed more light on the effectiveness of VR interventions for traumatized victims of crime.
| S-EPMC9306974 | biostudies-literature
Project description:PurposeRelaxation has significant restorative properties and implications for public health. However, modern, busy lives leave limiting time for relaxation. Virtual reality (VR) experiences of pleasant and calming virtual environments, accessed with a head-mounted display (HMD), appear to promote relaxation. This study aimed to provide a systematic review of feasibility, acceptability, and effectiveness of studies that use VR to promote relaxation in the general population (PROSPERO 195,804).MethodsWeb of Science, PsycINFO, Embase, and MEDLINE were searched until 29th June 2020. Studies were included in the review if they used HMD technology to present virtual environments that aimed to promote or measure relaxation, or relaxation-related variables. The Effective Public Health Practice Project (EPHPP) quality assessment tool was used to assess methodological quality of studies.Results6403 articles were identified through database searching. Nineteen studies published between 2007 and 2020, with 1278 participants, were included in the review. Of these, thirteen were controlled studies. Studies predominantly used natural audio-visual stimuli to promote relaxation. Findings indicate feasibility, acceptability, and short-term effectiveness of VR to increase relaxation and reduce stress. Six studies received an EPHPP rating of 'strong', seven were 'moderate', and six were 'weak'.ConclusionsVR may be a useful tool to promote relaxation in the general population, especially during the COVID-19 pandemic, when stress is increasing worldwide. However, methodological limitations, such as limited randomised controlled trials and longer-term evidence, mean that these conclusions should be drawn with caution. More robust studies are needed to support this promising area of VR relaxation.
| S-EPMC8197783 | biostudies-literature
Project description:BackgroundRobot-assisted therapy has become a promising technology in the field of rehabilitation for poststroke patients with motor disorders. Motivation during the rehabilitation process is a top priority for most stroke survivors. With current advancements in technology there has been the introduction of virtual reality (VR), augmented reality (AR), customizable games, or a combination thereof, that aid robotic therapy in retaining, or increasing the interests of, patients so they keep performing their exercises. However, there are gaps in the evidence regarding the transition from clinical rehabilitation to home-based therapy which calls for an updated synthesis of the literature that showcases this trend. The present review proposes a categorization of these studies according to technologies used, and details research in both upper limb and lower limb applications.ObjectiveThe goal of this work was to review the practices and technologies implemented in the rehabilitation of poststroke patients. It aims to assess the effectiveness of exoskeleton robotics in conjunction with any of the three technologies (VR, AR, or gamification) in improving activity and participation in poststroke survivors.MethodsA systematic search of the literature on exoskeleton robotics applied with any of the three technologies of interest (VR, AR, or gamification) was performed in the following databases: MEDLINE, EMBASE, Science Direct & The Cochrane Library. Exoskeleton-based studies that did not include any VR, AR or gamification elements were excluded, but publications from the years 2010 to 2017 were included. Results in the form of improvements in the patients' condition were also recorded and taken into consideration in determining the effectiveness of any of the therapies on the patients.ResultsThirty studies were identified based on the inclusion criteria, and this included randomized controlled trials as well as exploratory research pieces. There were a total of about 385 participants across the various studies. The use of technologies such as VR-, AR-, or gamification-based exoskeletons could fill the transition from the clinic to a home-based setting. Our analysis showed that there were general improvements in the motor function of patients using the novel interfacing techniques with exoskeletons. This categorization of studies helps with understanding the scope of rehabilitation therapies that can be successfully arranged for home-based rehabilitation.ConclusionsFuture studies are necessary to explore various types of customizable games required to retain or increase the motivation of patients going through the individual therapies.
| S-EPMC6779025 | biostudies-literature
Project description:PurposeIn laparoscopic surgery training, experts guide novice physicians to desired instrument positions or indicate relevant areas of interest. These instructions are usually given via verbal communication or using physical pointing devices. To facilitate a sterile work flow and to improve training, new guiding methods are needed. This work proposes to use optical see-through augmented reality to visualize an interactive virtual pointer on the laparoscopic.MethodsAfter an interdisciplinary development, the pointer's applicability and feasibility for training was evaluated and it was compared to a standard condition based on verbal and gestural communication only. In this study, ten surgical trainees were guided by an experienced trainer during cholecystectomies on a laparoscopic training simulator. All trainees completed a virtual cholecystectomy with and without the interactive virtual pointer in alternating order. Measures included procedure time, economy of movement and error rates.ResultsResults of standardized variables revealed significantly improved economy of movement (p = 0.047) and error rates (p = 0.047), as well as an overall improved user performance (Total z-score; p = 0.031) in conditions using the proposed method.ConclusionThe proposed HoloPointer is a feasible and applicable tool for laparoscopic surgery training. It improved objective performance metrics without prolongation of the task completion time in this pre-clinical setup.
| S-EPMC7822765 | biostudies-literature