Go Virtual Medical Ltd. -

The GVM Integrated Simulator

Knowledge decay occurs when skills acquired are not put into regular use. Courses are usually held at the start of a junior health professional’s clinical career, and there often is no ongoing experience in these skills because of the constant rotation of junior staff. The long gaps between utilizing the skills also results in confidence decay 2.

There is therefore a need to continue the ongoing experience to maintain these skills and confidence levels. Simulators address this need and facilitate the retention of procedural skills and confidence 7.

The tried and tested method of using text, video and anatomy is still fundamental in acquiring medical and nursing skills 15- 19 and should not be abandoned.

Integration of these teaching methods is an excellent way to maximize the skills acquired 3. The Integrated Simulator (IS) from Go Virtual Medical achieves this by combining instructional text, applied anatomy, an instructional narrative video and a simulator relating to medical and nursing procedures. The IS has face, content and construct validity for basic surgical trainees and is a useful pre-learning tool prior to clinical training 1 . It also has the additional benefit of being able to measure knowledge and performance in a logbook. The easy availability of the IS allows users to repeatedly practice their skills in virtual reality, thus minimizing the decay of knowledge and confidence that occurs amongst junior staff. This knowledge survives the barriers between international curricula 4.

Integrated Simulator

Randomized controlled trial: 1. Ben Loveday, George Oosthuizen, Scott Diener, John A Windsor. The validity of an integrated clinical simulator for learning laparoscopic appendicectomy. Presented at the RACS Annual Scientific Congress 2007. Abstract.
Non-randomized prospective study
: 2. Patel M, Oosthuizen G, Windsor JA. Clinical procedural skills: the impact of a training course and ongoing experience on confidence for junior doctors. Submitted for publication. Abstract.
Expert opinions
: 3. Kneebone R. Simulation in surgical training: educational issues and practical implications. Med Educ. 2003 Mar;37(3):267-77. PMID: 12603766.
4. Issenberg SB, Pringle S, Harden RM, Khogali S, Gordon MS. Adoption and integration of simulation-based learning technologies into the curriculum of a UK Undergraduate Education Programme. Med Educ. 2003 Nov;37 Suppl 1:42-9. PMID: 14641638.

Simulation

Randomized controlled trials

5. Seymour NE, Gallagher AG, Roman SA, O'Brien MK, Bansal VK, Andersen DK, Satava RM. Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg. 2002 Oct;236(4):458-63; discussion 463-4. PMID: 12368674.

6. Hart R, Doherty DA, Karthigasu K, Garry R. The value of virtual reality-simulator training in the development of laparoscopic surgical skills. J Minim Invasive Gynecol. 2006 Mar-Apr;13(2):126-33. PMID: 16527715 .

7. Stefanidis D, Korndorffer JR, Markley S, Sierra R, Scott DJ. Proficiency maintenance: impact of ongoing simulator training on laparoscopic skill retention. J Am Coll Surg. 2006 Apr;202(4):599-603. PMID: 16571429.

8. Steadman RH, Coates WC, Huang YM, Matevosian R, Larmon BR, McCullough L, Ariel D. Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Crit Care Med. 2006 Jan;34(1):151-7. PMID: 16374169.

9. Cosman PH, Hugh TJ, Shearer CJ, Merrett ND, Biankin AV, Cartmill JA. Skills acquired on virtual reality laparoscopic simulators transfer into the operating room in a blinded, randomised, controlled trial. Stud Health Technol Inform. 2007;125:76-81. PMID: 17377238.

10. Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg. 2004 Feb;91(2):146-50. PMID: 14760660.

Systematic review

11. Gallagher AG, Ritter EM, Champion H, Higgins G, Fried MP, Moses G, Smith CD, Satava RM. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg. 2005 Feb;241(2):364-72. PMID: 15650649.

Non-randomized prospective studies

12. Weller JM. Simulation in undergraduate medical education: bridging the gap between theory and practice. Med Educ. 2004 Jan;38(1):32-8. PMID: 14962024.

13. Jacomides L. Ogan K. Cadeddu JA. Pearle MS. Use of a virtual reality simulator for ureteroscopy training. Journal of Urology. 171(1):320-3; discussion 323, 2004 Jan. PMID: 14665905.

Expert opinion

14. Satava RM. Surgical education and surgical simulation. World J Surg. 2001 Nov;25(11):1484-9. PMID: 11760753.

Video

Randomized controlled trials: 15. Xeroulis GJ, Park J, Moulton CA, Reznick RK, Leblanc V, Dubrowski A. Teaching suturing and knot-tying skills to medical students: a randomized controlled study comparing computer-based video instruction and (concurrent and summary) expert feedback. Surgery. 2007 Apr;141(4):442-9. Epub 2007 Jan 25. PMID: 17383520.
16. Jowett N, LeBlanc V, Xeroulis G, MacRae H, Dubrowski A. Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg. 2007 Feb;193(2):237-42. PMID: 17236854.
Non-randomized prospective studies
: 17. Champion JK, Hunter J, Trus T, Laycock W. Teaching basic video skills as an aid in laparoscopic suturing. Surg Endosc. 1996 Jan;10(1):23-5. PMID: 8711599.

Anatomy

Randomized controlled trials: 18. Nicholson DT, Chalk C, Funnell WR, Daniel SJ. Can virtual reality improve anatomy education? A randomised controlled study of a computer-generated three-dimensional anatomical ear model. Med Educ. 2006 Nov;40(11):1081-7. PMID: 17054617.
Non-randomized prospective studies
: 19. Hariri S, Rawn C, Srivastava S, Youngblood P, Ladd A. Evaluation of a surgical simulator for learning clinical anatomy. Med Educ. 2004 Aug;38(8):896-902. PMID: 15271051.

Research