Training Using Immersive Virtual Reality
Cognitive Load and Performance in Immersive Virtual Reality Versus Conventional Virtual Reality Simulation Training of Laparoscopic Surgery - a Randomized Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Østerbro
-
Copenhagen, Østerbro, Denmark, 2100
- Copenhagen Academy for Medical Education and Simulation
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- First year resident
Exclusion Criteria:
- Previous participation in trials involving laparoscopic training
- Prior experience with laparoscopic surgery (having performed one or more laparoscopic procedures as primary surgeon, including supervised procedures)
- Not speaking Danish on a conversational level
Study Plan
How is the study designed?
Design Details
- Primary Purpose: OTHER
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
OTHER: Immersive virtual reality
Completing the procedures in immersive virtual reality
|
In the IVR environment, four different 360-degrees videos were in sequence played as backdrop during the procedure.
The videos reflected real life situations in the operating room with two videos representing calm periods, one video representing a light stressor and one video representing a severe stressor with a bleeding (2 ml/s) being triggered in the simulation.
Participants complete the procedures while wearing the head mounted device.
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|
NO_INTERVENTION: Conventional virtual reality
Completing the procedures in conventional virtual reality
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cognitive load
Time Frame: 6 months
|
Measurement of the participants cognitive load during four different time periods during the three procedures.
Cognitive load was estimated by secondary-task reaction time.
The investigators used an external and commercially available reaction timer (American Educational Products LLC, USA) to measure participants response time (in hundreds seconds) to an auditory stimulus (a beep).
Reaction time was measured before and after the simulation to provide an individual baseline, and during the simulation at t=80 s, t=130 s, t=180 s and t=240 s.
All reaction time measurements were done in series of four repeated measurements.
It was also noted if the reaction time was measured while the participant was using the foot pedal for cauterization in the simulation.
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to completion of procedure
Time Frame: 6 months
|
Time to completion of procedure (measured in seconds)
|
6 months
|
|
Diathermy damage
Time Frame: 6 months
|
Damage to surrounding tissue during the procedure (in number of incidents)
|
6 months
|
|
Blood loss
Time Frame: 6 months
|
Blood loss during the procedure (in ml)
|
6 months
|
|
Efficience of instrument movements (length)
Time Frame: 6 months
|
Measurement of movement of the left and right hand in meters
|
6 months
|
|
Efficience of instrument movements (degrees)
Time Frame: 6 months
|
Measurement of angular movements of the left and right hand in degrees
|
6 months
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Motion sickness
Time Frame: 6 months
|
Motion sickness was assessed using a post-procedure questionnaire.
The investigators used the MSAQ (Motion Sickness Assesment Questionnaire) developed by Gianaros et al in 2001.
The questionnaire consisted of 16 statements and the participants had to rate how accurately the statements describe their experience in a numbered scale from 1 (not at all) to 9 (severely).
The 16 statements were divided into for categories: Gastrointestinal; Central; Peripheral; Sopite-related.
The overall motion sickness score was obtained by calculating the percentage of total points scored: (sum of points from all items/144) * 100.
Subscale scores was obtained by calculating the percent of points scored within each factor: (sum of gastrointestinal items/36) * 100; (sum of central items/45) * 100; (sum of peripheral items/27) * 100; (sum of sopite-related items/36) * 100.
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Lars Konge, PhD, Copenhagen Academy for Medical Education and Simulation
Publications and helpful links
General Publications
- Strandbygaard J, Bjerrum F, Maagaard M, Winkel P, Larsen CR, Ringsted C, Gluud C, Grantcharov T, Ottesen B, Sorensen JL. Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized trial. Ann Surg. 2013 May;257(5):839-44. doi: 10.1097/SLA.0b013e31827eee6e.
- Sorensen SM, Savran MM, Konge L, Bjerrum F. Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review. Surg Endosc. 2016 Jan;30(1):11-23. doi: 10.1007/s00464-015-4189-7. Epub 2015 Apr 4.
- Nagendran M, Gurusamy KS, Aggarwal R, Loizidou M, Davidson BR. Virtual reality training for surgical trainees in laparoscopic surgery. Cochrane Database Syst Rev. 2013 Aug 27;2013(8):CD006575. doi: 10.1002/14651858.CD006575.pub3.
- Moorthy K, Munz Y, Adams S, Pandey V, Darzi A. A human factors analysis of technical and team skills among surgical trainees during procedural simulations in a simulated operating theatre. Ann Surg. 2005 Nov;242(5):631-9. doi: 10.1097/01.sla.0000186298.79308.a8.
- van Merrienboer JJ, Sweller J. Cognitive load theory in health professional education: design principles and strategies. Med Educ. 2010 Jan;44(1):85-93. doi: 10.1111/j.1365-2923.2009.03498.x.
- Huber T, Paschold M, Hansen C, Wunderling T, Lang H, Kneist W. New dimensions in surgical training: immersive virtual reality laparoscopic simulation exhilarates surgical staff. Surg Endosc. 2017 Nov;31(11):4472-4477. doi: 10.1007/s00464-017-5500-6. Epub 2017 Apr 4.
- Andersen SA, Mikkelsen PT, Konge L, Caye-Thomasen P, Sorensen MS. Cognitive Load in Mastoidectomy Skills Training: Virtual Reality Simulation and Traditional Dissection Compared. J Surg Educ. 2016 Jan-Feb;73(1):45-50. doi: 10.1016/j.jsurg.2015.09.010. Epub 2015 Oct 21.
- Thorson CM, Kelly JP, Forse RA, Turaga KK. Can we continue to ignore gender differences in performance on simulation trainers? J Laparoendosc Adv Surg Tech A. 2011 May;21(4):329-33. doi: 10.1089/lap.2010.0368.
- White MT, Welch K. Does gender predict performance of novices undergoing Fundamentals of Laparoscopic Surgery (FLS) training? Am J Surg. 2012 Mar;203(3):397-400; discussion 400. doi: 10.1016/j.amjsurg.2011.09.020.
- Gianaros PJ, Muth ER, Mordkoff JT, Levine ME, Stern RM. A questionnaire for the assessment of the multiple dimensions of motion sickness. Aviat Space Environ Med. 2001 Feb;72(2):115-9.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- HMD-VR
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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