以熟练度为依据的膀胱镜虚拟现实模拟技能培训实证的有效性

A proficiency-based empirical study of cystoscopy VR simulation skill training

目的探索以专家熟练度为依据建立软性膀胱镜技能考核标准的实证有效性。方法通过URO-Mentor模拟器获取软性膀胱镜专家(经验≥500例)技能表现数据,以其技能数据的70%[操作时间93.17 s,综合评估量表(GRS)评分15.55分]作为考核达标标准,且要求膀胱探查率达到80%及以上,其他指标还包括:任务4的操作时间、GRS。初学者训练达标后从中随机抽取10名受试者,在专家监督下完成膀胱镜操作并评价表现。结果共20名初学者和2名专家进入研究。初学者平均达标时间13.48 h,且较初始水平操作时间显著缩短(81.60±8.83 vs.311.05±116.22,P<0.001),GRS评分显著提升(17.92±1.07 vs.8.48±1.43,P<0.001)。10名受试者经临床操作测试,均达到可独立操作水平。结论以专家熟练度的70%作为膀胱镜技能考核标准是可行的。URO-Mentor虚拟模拟器是软性膀胱镜技能考核的有效工具。

Objective To explore and verify the assessment method and criteria of flexible cystoscopy skills based on the proficiency of experts.Methods The performance data of experts(experience≥500 cases)with flexible cystoscopy on the URO-Mentor TM was obtained,and 70%of the data was used as the assessment criteria(operating time 93.17 s,GRS score 15.55).The bladder exploration rate was required to reach 80%or above.Total operating time of task 4 and GRS scores were also assessed.After beginners performance data reached the criteria,10 beginners were selected randomly to complete the cystoscopy operation under the supervision of experts and their performance was assessed.Results A total of 20 beginners and 2 experts were included into the study.It took an average of 13.48 h for beginners to be qualified.Compared with the initial level,total operating time was significantly shorter(81.60±8.83 vs.311.05±116.22,P<0.001),and the GRS score was significantly improved(17.92±1.07 vs.8.48±1.43,P<0.001).Ten qualified beginners were able to perform flexible cystoscopy on patients independently.Conclusion It is feasible to use 70%of experts proficiency as the criteria for flexible cystoscopy skills assessment.The URO-Mentor VR Simulator is an effective tool to assess flexible cystoscopy skills.