Development of a structured virtual reality curriculum for laparoscopic appendicectomy

Am J Surg. 2020 Apr;219(4):613-621. doi: 10.1016/j.amjsurg.2019.04.020. Epub 2019 May 6.

Abstract

Background: Laparoscopic appendicectomy (LA) is a common surgical emergency procedure mainly performed by trainees. The aim was to develop a step-wise structured virtual reality (VR) curriculum for LA to allow junior surgeons to hone their skills in a safe and controlled environment.

Methods: A prospective randomized study was designed using a high-fidelity VR simulator. Thirty-five novices and 25 experts participated in the assessment and their performances were compared to assess construct validity. Learning curve analysis was performed.

Results: Five of the psychomotor tasks and all appendicectomy tasks showed construct validity. Learning was demonstrated in the majority of construct-valid tasks. A novel goal-directed VR curriculum for LA was constructed.

Conclusions: A step-wise structured VR curriculum for LA is proposed with a framework which includes computer generated metrics and supports deliberate practice, spacing intervals, human instruction/feedback and assessment. Future study should test the feasibility of its implementation and transferability of acquired skill.

Keywords: Curriculum development; Laparoscopic appendicectomy; Simulation; Surgical training; Virtual reality.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Appendectomy / education*
  • Curriculum*
  • Female
  • Humans
  • Laparoscopy / education*
  • Learning Curve
  • London
  • Male
  • Prospective Studies
  • Simulation Training / methods*
  • Virtual Reality*