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Meta-Analysis
. 2020 Nov;102(9):672-684.
doi: 10.1308/rcsann.2020.0178. Epub 2020 Aug 21.

Virtual reality training compared with apprenticeship training in laparoscopic surgery: a meta-analysis

M Portelli  1 , S F Bianco  1 , T Bezzina  2 , J E Abela  1
Affiliations
Meta-Analysis

Virtual reality training compared with apprenticeship training in laparoscopic surgery: a meta-analysis

M Portelli et al. Ann R Coll Surg Engl. 2020 Nov.

Abstract

Introduction: Since its inception, laparoscopic surgery has evolved and new techniques have been developed due to technological advances. This requires a different and more complex skill set in comparison with open surgery. Reduced working hours, less training time and patient safety factors demand that such skills need to be achieved outside the operating theatre environment. Several studies have been published and have determined the effectiveness of virtual reality training. We aimed to compare virtual reality training with the traditional apprenticeship method of training and determine whether it can supplement or replace the traditional apprenticeship model. We also aimed to perform a meta-analysis of the literature and develop conclusions with respect to the benefits achieved by adding virtual reality training on a regular basis to surgical training programmes.

Methods: A literature search was carried out on PubMed, MEDLINE, EMBASE and Google Scholar academic search engines using the MESH terms 'randomised controlled trials', 'virtual reality', 'laparoscopy', 'surgical education' and 'surgical training'. All randomised controlled trials published to January 2018 comparing virtual reality training to apprenticeship training were included. Data were collected on improved dexterity, operative performance and operating times. Each outcome was calculated with 95% confidence intervals and with intention-to-treat analysis; 24 randomised controlled trials were analysed.

Findings: Meta-analytical data were extracted for time, path length, instrument handling, tissue handling, error scores and objective structure assessment of technical skills scoring. There was significant improvement in individual trainee skill in all meta-analyses (p < 0.0002).

Conclusion: This meta-analysis shows that virtual reality not only improves efficiency in the trainee's surgical practice but also improves quality with reduced error rates and improved tissue handling.

Keywords: Apprenticeship training; Laparoscopy; Patient safety; Randomised controlled trials; Virtual reality.

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Figures

Figure 1
Figure 1
Flow diagram illustrating the studies included
Figure 2
Figure 2
Forrest plot for operative time of virtual reality (VR) compared with traditional training (TT)
Figure 3
Figure 3
Forrest plot for path length of virtual reality (VR) compared with traditional training (TT)
Figure 4
Figure 4
Forrest plot for instrument handling of virtual reality (VR) compared with traditional training (TT)
Figure 5
Figure 5
Forrest plot for tissue handling of virtual reality (VR) compared with traditional training (TT)
Figure 6
Figure 6
Forrest plot for error scores of virtual reality (VR) compared with traditional training (TT)
Figure 7
Figure 7
Forrest plot for objective structured assessment of technical skills score of virtual reality (VR) compared with traditional training (TT)
See this image and copyright information in PMC

References

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