Individualized Deliberate Practice on a Virtual Reality Simulator

Individualized Deliberate Practice on a Virtual Reality Simulator Improves Technical Performance of Surgical Novices in the Operating Room: A Randomized Controlled Trial

Training on simulated models in a surgical skills laboratory has been shown to improve technical performance in the operating room. Currently described simulation-based curricula consist of trainees practicing the same tasks until expert proficiency is reached. It has yet to be investigated whether individualized deliberate practice, where curricula tasks vary depending on prior levels of technical proficiency, would translate to the operating room.

This randomized controlled trial effectively demonstrates that deliberate practice on a virtual reality simulator results in an improvement in technical skills in a real clinical situation. This enhances the feasibility of implementing simulation-based curricula into residency training programs, and consequently has the potential to improve patient safety.

Study Overview

• Status: Completed
• Conditions: Education; General Surgery
• Intervention / Treatment: Other: Deliberate Practice

• Study Type: Interventional
• Enrollment (Actual): 16
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada
      • University of Toronto

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: ADULT; OLDER_ADULT; CHILD
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• post graduate year 1 and 2 surgical residents
• performed less than 10 laparoscopic cholecystectomies as the primary surgeon

Exclusion Criteria:

• n/a

Study Plan

How is the study designed?

Design Details

• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Deliberate Practice; Residents in the deliberate practice group received individualized feedback at the end of the initial assessment case. The staff surgeon supervising the case completed 3 previously validated technical skills assessment forms.	Other: Deliberate Practice
No Intervention: Conventional Feedback; Residents in the control group received informal feedback as they performed the initial laparoscopic cholecystectomy in the operating room. This was left up to the discretion of the staff surgeon supervising the operation. This corresponds to the routine teaching and feedback practices that occur during conventional surgical residency training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Technical skills	Participants' technical skills will be assessed in the operating room as they perform a laparoscopic cholecystectomy under supervision. The procedure will be video-recorded and sent for assessment to a blinded evaluator. Technical skills will be assessed using a previously validated technical skills assessment tool (Objective Structured Assessment of Technical Skill - OSATS)	6 months

Collaborators and Investigators

• Sponsor: Unity Health Toronto
• Collaborators: Royal College of Physicians and Surgeons of Canada

Study record dates

Study Major Dates

• Study Start: January 1, 2008
• Primary Completion (Actual): January 1, 2011
• Study Completion (Actual): January 1, 2011

Study Registration Dates

• First Submitted: December 7, 2012
• First Submitted That Met QC Criteria: December 17, 2012
• First Posted (Estimate): December 20, 2012

Study Record Updates

• Last Update Posted (Estimate): December 20, 2012
• Last Update Submitted That Met QC Criteria: December 17, 2012
• Last Verified: December 1, 2012

More Information

Terms related to this study

• Other Study ID Numbers: Deliberate Practice