Randomized controlled trial of virtual reality simulator training: transfer to live patients

  • Jason Park
    Affiliations
    Faculty of Medicine, Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth St, 1ES-565, Toronto, Ontario, Canada M5G 2C4

    Department of Surgery, University of Toronto, Banting Institute, 100 College St, Rm 311, Toronto, Ontario, Canada M5G 1L5
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  • Helen MacRae
    Affiliations
    Faculty of Medicine, Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth St, 1ES-565, Toronto, Ontario, Canada M5G 2C4

    Department of Surgery, University of Toronto, Banting Institute, 100 College St, Rm 311, Toronto, Ontario, Canada M5G 1L5
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  • Laura J. Musselman
    Affiliations
    Faculty of Medicine, Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth St, 1ES-565, Toronto, Ontario, Canada M5G 2C4

    Department of Surgery, University of Toronto, Banting Institute, 100 College St, Rm 311, Toronto, Ontario, Canada M5G 1L5
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  • Peter Rossos
    Affiliations
    Department of Medicine, University of Toronto, Ste RFE 3-805, 190 Elizabeth St, Toronto, Ontario, Canada M5G 2C4
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  • Stanley J. Hamstra
    Correspondence
    Corresponding author. Department of Medical Education, University of Michigan Medical School, G1208 Towsley, Box 201, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0201. Tel.: +1-734-763-1424; fax: +1-734-936-1641.
    Affiliations
    Faculty of Medicine, Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth St, 1ES-565, Toronto, Ontario, Canada M5G 2C4

    Department of Surgery, University of Toronto, Banting Institute, 100 College St, Rm 311, Toronto, Ontario, Canada M5G 1L5
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  • Stephen Wolman
    Affiliations
    Department of Medicine, University of Toronto, Ste RFE 3-805, 190 Elizabeth St, Toronto, Ontario, Canada M5G 2C4
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  • Richard K. Reznick
    Affiliations
    Faculty of Medicine, Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth St, 1ES-565, Toronto, Ontario, Canada M5G 2C4

    Department of Surgery, University of Toronto, Banting Institute, 100 College St, Rm 311, Toronto, Ontario, Canada M5G 1L5
    Search for articles by this author

      Abstract

      Background

      New Residency Review Committee requirements in general surgery require 50 colonoscopies. Simulators have been widely suggested to help prepare residents for live clinical experience. We assessed a computer-based colonoscopy simulator for effective transfer of skills to live patients.

      Methods

      A randomized controlled trial included general surgery and internal medicine residents with limited endoscopic experience. Following a pretest, the treatment group (n = 12) practiced on the simulator, while controls (n = 12) received no additional training. Both groups then performed a colonoscopy on a live patient. Technical ability was evaluated by expert endoscopists using previously validated assessment instruments.

      Results

      In the live patient setting, the treatment group scored significantly higher global ratings than controls (t(22) = 1.84, P = .04). Only 2 of the 8 computer-based performance metrics correlated significantly with previously validated global ratings of performance.

      Conclusions

      Residents trained on a colonoscopy simulator prior to their first patient-based colonoscopy performed significantly better in the clinical setting than controls, demonstrating skill transfer to live patients. The simulator’s performance metrics showed limited concurrent validity, suggesting the need for further refinement.

      Keywords

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