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- Berry, Max, 1969, et al.
(författare)
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Endovascular training with animals versus virtual reality systems: an economic analysis
- 2008
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Ingår i: J Vasc Interv Radiol. - : Elsevier BV. - 1051-0443. ; 19:2 Pt 1, s. 233-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess the relative costs of a virtual reality (VR) laboratory and an animal laboratory for endovascular skills training. MATERIALS AND METHODS: Cost data extracted from a previous experiment was used to perform a financial analysis according to the guidelines published by the National Institutes of Health. The analysis compared the purchase or rental of a Procedicus Vascular Interventional System Trainer to the rental of an animal laboratory. RESULTS: The VR laboratory course cost $3,434 per trainee versus $4,634 in the animal laboratory according to the purchase-versus-rental analysis. The cost ratio was 0.74 in favor of the VR laboratory. Cost ratio sensitivity analysis ranged from 0.25 in favor of the VR laboratory to 2.22 in favor of the animal laboratory. The first-year potential savings were $62,410 assuming exclusive use of the VR laboratory. The 5-year training savings totaled $390,376, excluding the $60,000 residual value of the simulator. Simulator rental reduced the course price to $1,076 per trainee and lowered the cost ratio to 0.23 in favor of the VR laboratory. Findings of sensitivity analysis ranged from 0.08 to 0.70 in favor of the VR laboratory. The first-year and 5-year potential national savings increased to $185,026 and $1,013,238, respectively. CONCLUSIONS: Although evidence remains sparse that the training of interventional skills in artificial environments translates to better performance in human procedures, there are good pedagogic grounds on which to believe that such training will become increasingly important. The present comparison of the direct costs of two such models suggests that VR training is less expensive than live animal training.
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- Berry, Max, 1969, et al.
(författare)
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Porcine transfer study: virtual reality simulator training compared with porcine training in endovascular novices
- 2007
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Ingår i: Cardiovasc Intervent Radiol. - : Springer Science and Business Media LLC. - 0174-1551. ; 30:3, s. 455-61
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To compare the learning of endovascular interventional skills by training on pig models versus virtual reality simulators. METHODS: Twelve endovascular novices participated in a study consisting of a pig laboratory (P-Lab) and a virtual reality laboratory (VR-Lab). Subjects were stratified by experience and randomized into four training groups. Following 1 hr of didactic instruction, all attempted an iliac artery stenosis (IAS) revascularization in both laboratories. Onsite proctors evaluated performances using task-specific checklists and global rating scales, yielding a Total Score. Participants completed two training sessions of 3 hr each, using their group's assigned method (P-Lab x 2, P-Lab + VR-Lab, VR-Lab + P-Lab, or VR-Lab x 2) and were re-evaluated in both laboratories. A panel of two highly experienced interventional radiologists performed assessments from video recordings. ANCOVA analysis of Total Score against years of surgical, interventional radiology (IR) experience and cumulative number of P-Lab or VR-Lab sessions was conducted. Inter-rater reliability (IRR) was determined by comparing proctored scores with the video assessors in only the VR-Lab. RESULTS: VR-Lab sessions improved the VR-Lab Total Score (beta = 3.029, p = 0.0015) and P-Lab Total Score (beta = 1.814, p = 0.0452). P-Lab sessions increased the P-Lab Total Score (beta = 4.074, p < 0.0001) but had no effect on the VR-Lab Total Score. In the general statistical model, both P-Lab sessions (beta = 2.552, p = 0.0010) and VR-Lab sessions (beta = 2.435, p = 0.0032) significantly improved Total Score. Neither previous surgical experience nor IR experience predicted Total Score. VR-Lab scores were consistently higher than the P-Lab scores (Delta = 6.659, p < 0.0001). VR-Lab IRR was substantial (r = 0.649, p < 0.0008). CONCLUSIONS: Endovascular skills learned in the virtual environment may be transferable to the real catheterization laboratory as modeled in the P-Lab.
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- Berry, Max, 1969, et al.
(författare)
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The use of virtual reality for training in carotid artery stenting: a construct validation study
- 2008
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Ingår i: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 49:7, s. 801-5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Given that carotid artery stenosis (CAS) intervention is procedurally difficult, possesses an extensive learning curve, and involves a grave list of potential complications, construct validation of new non-clinical training devices is of increasing importance. Purpose: To evaluate the construct validity of the Procedicus-Virtual Interventional Simulator Trainer (Procedicus-VIST) and its use as a training tool. Material and Methods: Sixteen interventionalists (15 males, one female; mean interventional radiology [IR] experience >11 years) and 16 medical students (15 males, one female; no IR experience) received 1 hour of didactic instruction followed by an hour of familiarization training. Subjects then attempted to complete a carotid artery stenting procedure within 1 hour while their performance metrics were recorded. All participants completed a qualitative exit survey of subjective parameters using a visual analog scale. Results: Procedure and fluoroscopic time was 8.7 and 8.7 min greater in the novice group (P=0.0066 and P=0.0031), respectively. There were no significant differences in performances between the two groups in the remaining metrics of cine loops (number recorded), tool/vessel ratio, coverage percentage, and placement accuracy or residual stenosis. Contrast measurement metrics were found to be too imprecise for statistical analysis. Experienced and novice opinions differed significantly for six of 10 subjective parameters. No statistically significant difference in video-gaming habits was demonstrated. Conclusion: With the exception of the metrics of performance time and fluoroscopic use, construct validity of the Procedicus-VIST carotid metrics were not confirmed. Virtual reality simulation as a training method was valued more by novices than by experienced interventionalists.
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- Max, Berry, 1969
(författare)
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Virtual Reality Simulations and Interventional Radiology
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTION: Use of virtual reality (VR) simulators in endovascular interventional education has become increasingly popular yet many questions surrounding this nascent technology remain unanswered. While progress has been made in other disciplines such as endoscopy and minimally invasive surgery, scientific evidence investigating endovascular simulations remains limited. The general aim of this dissertation was to conduct validation studies to elucidate the potential for skills acquisition and assessment outside of the catheterization laboratory using VR simulation. Endovascular skills transfer from VR-Lab to the porcine laboratory (P-Lab) was also investigated. An economic analysis was performed to assist in the establishment of a realistic VR implementation strategy. MATERIALS AND METHODS: Simulator validations were conducted by comparing performance metrics collected from novices and experienced physicians using Student?s t-test. Performance metrics were recorded by the simulator while participants treated simulated patients suffering from renal artery stenosis (RAS) and carotid artery stenosis (CAS). Endovascular skills transfer was tested using the P-Lab as an approximation of the human catheterization laboratory. A group of endovascular novices were evaluated in the P-Lab and the VR-Lab using an objective skills assessment of technical skills (OSATS), yielding a Total Score. Participants were then randomized into different training groups, put through their assigned training schema and subsequently re-evaluated in both laboratories. ANCOVA analysis was conducted to compare the cumulative effect each type of training had on Total Score. Consumable and rental fees from the skills transfer study were used to calculate the comparison data for the economical analysis. RESULTS: Face validity was demonstrated for both the renal and carotid artery stenosis modules. Neither construct validity study produced results which differentiated between the expert and novice performance metrics except for fluoroscopic and procedural times. VR-Lab training sessions generated skills which improved P-Lab performances. VR-Lab training cost less than the P-Lab using our economical analysis. CONCLUSIONS: Despite demonstrating face validity, VR-Lab simulations should not be used alone for skills assessment outside of the catheterization laboratory in its present form. Skills learned in virtual reality transfer favorably to the P-Lab and simulation training seems to offer a viable alternative of non-clinical training. The VR-Lab affords a more economical method to teach and practice endovascular skills compared to the P-lab. Further research is needed to elucidate the relative efficacies of both training methods
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