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Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads

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Abstract

Background

While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system’s performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training.

Methods

Thirty-two surgical trainees were randomly assigned to either the Control-Group (CG) or Experiment-Group (EG). While the CG participants reviewed the PM at their discretion, the EG participants had explanations about PM and instructions on how to improve scores. Each subject completed a 5-week training using four simulation tasks. Pre- and post-training data were collected using both a simulator and robot. Peri-training data were collected after each session. Skill learning, time spent on PM (TPM), and cognitive workloads were compared between groups.

Results

After the simulation training, CG showed substantially lower simulation task scores (82.9 ± 6.0) compared with EG (93.2 ± 4.8). Both groups demonstrated improved physical model tasks performance with the actual robot, but the EG had a greater improvement in two tasks. The EG exhibited lower global mental workload/distress, higher engagement, and a better understanding regarding using PM to improve performance. The EG’s TPM was initially long but substantially shortened as the group became familiar with PM.

Conclusion

Our study demonstrated that the current VR simulator offered limited self-skill learning and additional mentoring still played an important role in improving the robotic surgery simulation training.

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Acknowledgements

Dr. Gyusung Lee received the Association for Surgical Education Center for Excellence in Surgical Education, Research and Training (CESERT) Grant and Intuitive Surgical Clinical Robotic Research Grant as the Principle Investigator of this study. The authors acknowledge the generous support of Dr. Michael Marohn, the Director of MISTIC, and the thoughtful and careful assistance of Karyn Rhyder in editing this manuscript.

Funding

This project was supported by the Association for Surgical Education Center for Excellence in Surgical Education, Research and Training (CESERT) Grant and Intuitive Surgical Clinical Robotic Research Grant.

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Authors and Affiliations

  1. Department of Surgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street Blalock 1204, Baltimore, MD, 21287, USA

    Gyusung I. Lee & Mija R. Lee

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Correspondence to Gyusung I. Lee.

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Disclosures

Dr. Gyusung Lee received the Association for Surgical Education Center for Excellence in Surgical Education, Research and Training (CESERT) grant and Intuitive Surgical Clinical Robotic Research Grant for this study. Dr. Mija Lee was the co-investigator in this study and is Dr. Gyusung Lee’s spouse.

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Lee, G.I., Lee, M.R. Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads. Surg Endosc 32, 62–72 (2018). https://doi.org/10.1007/s00464-017-5634-6

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