Alexandre Tronchot, Julien Maximen, Tiphaine Casy, Harold Common, Hervé Thomazeau, Pierre Jannin, Arnaud Huaulmé
{"title":"虚拟现实模拟在关节镜技术技能评估中对外科住院医师心率的影响:一项前瞻性配对观察研究。","authors":"Alexandre Tronchot, Julien Maximen, Tiphaine Casy, Harold Common, Hervé Thomazeau, Pierre Jannin, Arnaud Huaulmé","doi":"10.1016/j.otsr.2024.103915","DOIUrl":null,"url":null,"abstract":"<p><strong>Hypothesis: </strong>To demonstrate that a virtual reality (VR) simulation training program reduces heart rate variability during an assessment of surgical trainees' technical skills in arthroscopy.</p><p><strong>Study design: </strong>Prospective observational matched study.</p><p><strong>Materials & methods: </strong>Thirty-six orthopaedic surgery residents, new to arthroscopy, received standard training in arthroscopic knee surgery, supplemented by additional monthly training for 6months on a VR simulator for 16 of them. At inclusion, the 2 groups (VR and NON-VR) answered a questionnaire and performed a meniscectomy on a VR simulator. After 6months of training, two independent trainers blinded to the inclusion arms evaluated the technical skills of the two groups during meniscectomies on a model and on an anatomical subject. Heart rate variability (HRV) was measured using a wireless heart rate monitor during baseline, VR training, and assessment.</p><p><strong>Results: </strong>After removing incomplete data, the analysis focused on 10 VR residents matched at inclusion with 10 NON-VR residents. The VR group had a significantly lower heart rate at the final assessment (p=0.02) and lower overall HRV (p=0.05). The low/high frequency ratio (LF/HF) was not significantly different between the groups (1.84 vs 2.05, p=0.66) but the before-after training comparison showed a greater decrease in this ratio in the VR group compared to the NON-VR group -0.76 (-41%) vs -0.08 (-4%).</p><p><strong>Conclusion: </strong>This study demonstrates a significant difference in heart rate variability between trained residents versus untrained residents during the final assessment of their technical skills at 6months. It appears that improving stress management should be an integral part of training programs in arthroscopic surgery.</p><p><strong>Clinical interest: </strong>VR simulators in arthroscopy could improve non-technical skills such as heart rate variability, from the perspective of accountability.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The influence of virtual reality simulation on surgical residents' heart rate during an assessment of arthroscopic technical skills: A prospective, paired observational study.\",\"authors\":\"Alexandre Tronchot, Julien Maximen, Tiphaine Casy, Harold Common, Hervé Thomazeau, Pierre Jannin, Arnaud Huaulmé\",\"doi\":\"10.1016/j.otsr.2024.103915\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Hypothesis: </strong>To demonstrate that a virtual reality (VR) simulation training program reduces heart rate variability during an assessment of surgical trainees' technical skills in arthroscopy.</p><p><strong>Study design: </strong>Prospective observational matched study.</p><p><strong>Materials & methods: </strong>Thirty-six orthopaedic surgery residents, new to arthroscopy, received standard training in arthroscopic knee surgery, supplemented by additional monthly training for 6months on a VR simulator for 16 of them. At inclusion, the 2 groups (VR and NON-VR) answered a questionnaire and performed a meniscectomy on a VR simulator. After 6months of training, two independent trainers blinded to the inclusion arms evaluated the technical skills of the two groups during meniscectomies on a model and on an anatomical subject. Heart rate variability (HRV) was measured using a wireless heart rate monitor during baseline, VR training, and assessment.</p><p><strong>Results: </strong>After removing incomplete data, the analysis focused on 10 VR residents matched at inclusion with 10 NON-VR residents. The VR group had a significantly lower heart rate at the final assessment (p=0.02) and lower overall HRV (p=0.05). The low/high frequency ratio (LF/HF) was not significantly different between the groups (1.84 vs 2.05, p=0.66) but the before-after training comparison showed a greater decrease in this ratio in the VR group compared to the NON-VR group -0.76 (-41%) vs -0.08 (-4%).</p><p><strong>Conclusion: </strong>This study demonstrates a significant difference in heart rate variability between trained residents versus untrained residents during the final assessment of their technical skills at 6months. It appears that improving stress management should be an integral part of training programs in arthroscopic surgery.</p><p><strong>Clinical interest: </strong>VR simulators in arthroscopy could improve non-technical skills such as heart rate variability, from the perspective of accountability.</p><p><strong>Level of evidence: </strong>III.</p>\",\"PeriodicalId\":54664,\"journal\":{\"name\":\"Orthopaedics & Traumatology-Surgery & Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-06-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Orthopaedics & Traumatology-Surgery & Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.otsr.2024.103915\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopaedics & Traumatology-Surgery & Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.otsr.2024.103915","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The influence of virtual reality simulation on surgical residents' heart rate during an assessment of arthroscopic technical skills: A prospective, paired observational study.
Hypothesis: To demonstrate that a virtual reality (VR) simulation training program reduces heart rate variability during an assessment of surgical trainees' technical skills in arthroscopy.
Study design: Prospective observational matched study.
Materials & methods: Thirty-six orthopaedic surgery residents, new to arthroscopy, received standard training in arthroscopic knee surgery, supplemented by additional monthly training for 6months on a VR simulator for 16 of them. At inclusion, the 2 groups (VR and NON-VR) answered a questionnaire and performed a meniscectomy on a VR simulator. After 6months of training, two independent trainers blinded to the inclusion arms evaluated the technical skills of the two groups during meniscectomies on a model and on an anatomical subject. Heart rate variability (HRV) was measured using a wireless heart rate monitor during baseline, VR training, and assessment.
Results: After removing incomplete data, the analysis focused on 10 VR residents matched at inclusion with 10 NON-VR residents. The VR group had a significantly lower heart rate at the final assessment (p=0.02) and lower overall HRV (p=0.05). The low/high frequency ratio (LF/HF) was not significantly different between the groups (1.84 vs 2.05, p=0.66) but the before-after training comparison showed a greater decrease in this ratio in the VR group compared to the NON-VR group -0.76 (-41%) vs -0.08 (-4%).
Conclusion: This study demonstrates a significant difference in heart rate variability between trained residents versus untrained residents during the final assessment of their technical skills at 6months. It appears that improving stress management should be an integral part of training programs in arthroscopic surgery.
Clinical interest: VR simulators in arthroscopy could improve non-technical skills such as heart rate variability, from the perspective of accountability.
期刊介绍:
Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.