Validation of the VBLaST Peg Transfer Task: A First Step towards an Alternate Training Standard
Identifieur interne : 000C91 ( Main/Merge ); précédent : 000C90; suivant : 000C92Validation of the VBLaST Peg Transfer Task: A First Step towards an Alternate Training Standard
Auteurs : A. Chellali [États-Unis, France] ; L. Zhang [États-Unis] ; G. Sankaranarayanan ; V. S. Arikatla ; W. Ahn ; A. Derevianko [États-Unis] ; S. D. Schwaitzberg [États-Unis] ; D. B. Jones [États-Unis] ; M. Demoya [États-Unis] ; C. G. L. Cao [États-Unis]Source :
- Surgical endoscopy [ 0930-2794 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
- education : Laparoscopy.
- Adult, Clinical Competence, Computer Simulation, Feedback, Female, Humans, Male, Middle Aged, User-Computer Interface.
- mix :
Abstract
The FLS trainer lacks objective and automated assessments of laparoscopic performance and requires a large supply of relatively expensive consumables. Virtual reality simulation has a great potential as a training and assessment tool of laparoscopic skills and can overcome some limitations of the FLS trainer. This study was carried out to assess the value of our Virtual Basic Laparoscopic Surgical Trainer (VBLaST©) in the peg transfer task compared to the FLS trainer and its ability to differentiate performance between novice, intermediate and expert groups.
Thirty subjects were divided into three groups: novices (PGY1-2, n = 10), intermediates (PGY3-4, n=10), and experts (PGY5, surgical fellows and attendings, n = 10). All subjects performed ten trials of the peg transfer task on each simulator. Assessment of laparoscopic performance was based on FLS scoring while a questionnaire was used for subjective evaluation.
The performance scores in the two simulators were correlated, though subjects performed significantly better in the FLS trainer. Experts performed better than novices only on the FLS trainer while no significant differences were observed between the other groups. Moreover, a significant learning effect was found on both trainers, with a greater improvement of performance on the VBLaST©. Finally, 82.6% of the subjects preferred the FLS over the VBLaST© for surgical training which could be attributed to the novelty of the VR technology and existing deficiencies of the user interface for the VBLaST©.
This study demonstrated that the VBLaST© reproduced faithfully some aspects of the FLS peg transfer task (such as color, size and shape of the peg board, etc.) while other aspects require additional development. Future improvement of the user interface and haptic feedback will enhance the value of the system as an alternative to the FLS as the standard training tool for laparoscopic surgery skills.
Url:
DOI: 10.1007/s00464-014-3538-2
PubMed: 24771197
PubMed Central: 4189970
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Chellali</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Department of Computing Engineering, University of Evry, IBISC Laboratory, Evry, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Computing Engineering, University of Evry, IBISC Laboratory, Evry</wicri:regionArea><placeName><region type="région">Île-de-France</region><settlement type="city">Évry (Essonne)</settlement></placeName></affiliation></author><author><name sortKey="Zhang, L" sort="Zhang, L" uniqKey="Zhang L" first="L." last="Zhang">L. Zhang</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Mechanical Engineering, Tufts University, Medford, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Mechanical Engineering, Tufts University, Medford, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Sankaranarayanan, G" sort="Sankaranarayanan, G" uniqKey="Sankaranarayanan G" first="G." last="Sankaranarayanan">G. Sankaranarayanan</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Arikatla, V S" sort="Arikatla, V S" uniqKey="Arikatla V" first="V. S." last="Arikatla">V. S. Arikatla</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Ahn, W" sort="Ahn, W" uniqKey="Ahn W" first="W." last="Ahn">W. Ahn</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Derevianko, A" sort="Derevianko, A" uniqKey="Derevianko A" first="A." last="Derevianko">A. Derevianko</name><affiliation wicri:level="2"><nlm:aff id="A5">Department of Surgery, Massachusetts General Hospital, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Massachusetts General Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Schwaitzberg, S D" sort="Schwaitzberg, S D" uniqKey="Schwaitzberg S" first="S. D." last="Schwaitzberg">S. D. Schwaitzberg</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Jones, D B" sort="Jones, D B" uniqKey="Jones D" first="D. B." last="Jones">D. B. Jones</name><affiliation wicri:level="2"><nlm:aff id="A6">Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Demoya, M" sort="Demoya, M" uniqKey="Demoya M" first="M." last="Demoya">M. Demoya</name><affiliation wicri:level="2"><nlm:aff id="A5">Department of Surgery, Massachusetts General Hospital, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Massachusetts General Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Cao, C G L" sort="Cao, C G L" uniqKey="Cao C" first="C. G. L." last="Cao">C. G. L. Cao</name><affiliation wicri:level="2"><nlm:aff id="A7">Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author></analytic><series><title level="j">Surgical endoscopy</title><idno type="ISSN">0930-2794</idno><idno type="eISSN">1432-2218</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Clinical Competence</term><term>Computer Simulation</term><term>Feedback</term><term>Female</term><term>Humans</term><term>Laparoscopy (education)</term><term>Male</term><term>Middle Aged</term><term>User-Computer Interface</term></keywords><keywords scheme="MESH" qualifier="education" xml:lang="en"><term>Laparoscopy</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Clinical Competence</term><term>Computer Simulation</term><term>Feedback</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>User-Computer Interface</term></keywords><keywords scheme="mix" xml:lang="en"><term>Fundamentals of Laparoscopic Skills (FLS)</term><term>Surgical training</term><term>Virtual Basic Laparoscopic Surgical Trainer (VBLaST)</term><term>force feedback</term><term>virtual reality (VR)</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">The FLS trainer lacks objective and automated assessments of laparoscopic performance and requires a large supply of relatively expensive consumables. Virtual reality simulation has a great potential as a training and assessment tool of laparoscopic skills and can overcome some limitations of the FLS trainer. This study was carried out to assess the value of our Virtual Basic Laparoscopic Surgical Trainer (VBLaST©) in the peg transfer task compared to the FLS trainer and its ability to differentiate performance between novice, intermediate and expert groups.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Thirty subjects were divided into three groups: novices (PGY1-2, n = 10), intermediates (PGY3-4, n=10), and experts (PGY5, surgical fellows and attendings, n = 10). All subjects performed ten trials of the peg transfer task on each simulator. Assessment of laparoscopic performance was based on FLS scoring while a questionnaire was used for subjective evaluation.</p></sec><sec id="S3"><title>Results</title><p id="P3">The performance scores in the two simulators were correlated, though subjects performed significantly better in the FLS trainer. Experts performed better than novices only on the FLS trainer while no significant differences were observed between the other groups. Moreover, a significant learning effect was found on both trainers, with a greater improvement of performance on the VBLaST©. Finally, 82.6% of the subjects preferred the FLS over the VBLaST© for surgical training which could be attributed to the novelty of the VR technology and existing deficiencies of the user interface for the VBLaST©.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">This study demonstrated that the VBLaST© reproduced faithfully some aspects of the FLS peg transfer task (such as color, size and shape of the peg board, etc.) while other aspects require additional development. Future improvement of the user interface and haptic feedback will enhance the value of the system as an alternative to the FLS as the standard training tool for laparoscopic surgery skills.</p></sec></div></front></TEI><double doi="10.1007/s00464-014-3538-2"><HAL><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Validation of the VBLaST Peg Transfer Task: A First Step toward an Alternate Training Standard</title><author><name sortKey="Chellali, Amine" sort="Chellali, Amine" uniqKey="Chellali A" first="Amine" last="Chellali">Amine Chellali</name><affiliation wicri:level="1"><hal:affiliation type="researchteam" xml:id="struct-398500" status="INCOMING"><orgName>IRA2</orgName><desc><address><country key="FR"></country></address></desc><listRelation><relation active="#struct-143247" type="direct"></relation><relation active="#struct-93105" type="indirect"></relation><relation active="#struct-236008" type="direct"></relation><relation active="#struct-356838" type="indirect"></relation></listRelation><tutelles><tutelle active="#struct-143247" type="direct"><org type="laboratory" xml:id="struct-143247" status="VALID"><orgName>Informatique, Biologie Intégrative et Systèmes Complexes</orgName><orgName type="acronym">IBISC</orgName><desc><address><addrLine>40 rue du Pelvoux, Courcouronnes ; 91020 Evry Cedex</addrLine><country key="FR"></country></address><ref type="url">http://www.ibisc.univ-evry.fr/</ref></desc><listRelation><relation active="#struct-93105" type="direct"></relation></listRelation></org></tutelle><tutelle active="#struct-93105" type="indirect"><org type="institution" xml:id="struct-93105" status="VALID"><orgName>Université d'Evry-Val d'Essonne</orgName><desc><address><addrLine>Boulevard François Mitterrand 91025 Evry Cedex</addrLine><country key="FR"></country></address><ref type="url">http://www.univ-evry.fr/fr/index.html</ref></desc></org></tutelle><tutelle active="#struct-236008" type="direct"><org type="laboratory" xml:id="struct-236008" status="INCOMING"><orgName>Interactive Surgical Systems Laboratory</orgName><orgName type="acronym">ISSyL</orgName><desc><address><addrLine>Cambridge</addrLine><country key="US"></country></address><ref type="url">http://www.issyl-lab.org</ref></desc><listRelation><relation active="#struct-356838" type="direct"></relation></listRelation></org></tutelle><tutelle active="#struct-356838" type="indirect"><org type="institution" xml:id="struct-356838" status="INCOMING"><orgName>Cambridge Health Alliance - Harvard Medical School</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Zhang, Likun" sort="Zhang, Likun" uniqKey="Zhang L" first="Likun" last="Zhang">Likun Zhang</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-236007" status="INCOMING"><orgName>Ergonomics in Remote Environments Laboratory</orgName><orgName type="acronym">EREL</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-211712" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-211712" type="direct"><org type="institution" xml:id="struct-211712" status="VALID"><orgName>Wright State University [Dayton]</orgName><desc><address><addrLine>3640 Colonel Glenn Hwy, Dayton, OH 45435</addrLine><country key="US"></country></address><ref type="url">http://www.wright.edu/</ref></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Sankaranarayanan, Ganesh" sort="Sankaranarayanan, Ganesh" uniqKey="Sankaranarayanan G" first="Ganesh" last="Sankaranarayanan">Ganesh Sankaranarayanan</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246732" status="INCOMING"><orgName>Center for Modeling, Simulation and Imaging in Medicine</orgName><orgName type="acronym">CMSIM</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-364148" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-364148" type="direct"><org type="institution" xml:id="struct-364148" status="INCOMING"><orgName>Rensselaer Polytechnic Institute</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Arikatla, V S" sort="Arikatla, V S" uniqKey="Arikatla V" first="V. S." last="Arikatla">V. S. Arikatla</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246732" status="INCOMING"><orgName>Center for Modeling, Simulation and Imaging in Medicine</orgName><orgName type="acronym">CMSIM</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-364148" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-364148" type="direct"><org type="institution" xml:id="struct-364148" status="INCOMING"><orgName>Rensselaer Polytechnic Institute</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Ahn, Woojin" sort="Ahn, Woojin" uniqKey="Ahn W" first="Woojin" last="Ahn">Woojin Ahn</name><affiliation wicri:level="1"><hal:affiliation type="researchteam" xml:id="struct-398501" status="INCOMING"><orgName>Center for Modeling, Simulation and Imaging in Medicine</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-246733" type="direct"></relation><relation active="#struct-364148" type="indirect"></relation></listRelation><tutelles><tutelle active="#struct-246733" type="direct"><org type="laboratory" xml:id="struct-246733" status="INCOMING"><orgName>Center for Modeling, Simulation and Imaging in Medicine</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-364148" type="direct"></relation></listRelation></org></tutelle><tutelle active="#struct-364148" type="indirect"><org type="institution" xml:id="struct-364148" status="INCOMING"><orgName>Rensselaer Polytechnic Institute</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Derevianko, A P" sort="Derevianko, A P" uniqKey="Derevianko A" first="A. P." last="Derevianko">A. P. Derevianko</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246734" status="INCOMING"><orgName>Department of Surgery</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-374583" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-374583" type="direct"><org type="institution" xml:id="struct-374583" status="INCOMING"><orgName>Massachusetts General Hospital</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Schwaitzberg, Steven D" sort="Schwaitzberg, Steven D" uniqKey="Schwaitzberg S" first="Steven D." last="Schwaitzberg">Steven D. Schwaitzberg</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-236008" status="INCOMING"><orgName>Interactive Surgical Systems Laboratory</orgName><orgName type="acronym">ISSyL</orgName><desc><address><addrLine>Cambridge</addrLine><country key="US"></country></address><ref type="url">http://www.issyl-lab.org</ref></desc><listRelation><relation active="#struct-356838" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-356838" type="direct"><org type="institution" xml:id="struct-356838" status="INCOMING"><orgName>Cambridge Health Alliance - Harvard Medical School</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Jones, Daniel B" sort="Jones, Daniel B" uniqKey="Jones D" first="Daniel B." last="Jones">Daniel B. Jones</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246735" status="INCOMING"><orgName>Department of Surgery</orgName><desc><address><country key="FR"></country></address></desc><listRelation><relation active="#struct-305601" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-305601" type="direct"><org type="institution" xml:id="struct-305601" status="INCOMING"><orgName>Beth Israel Deaconess Medical Center, Harvard Medical School</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Demoya, Marc" sort="Demoya, Marc" uniqKey="Demoya M" first="Marc" last="Demoya">Marc Demoya</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246734" status="INCOMING"><orgName>Department of Surgery</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-374583" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-374583" type="direct"><org type="institution" xml:id="struct-374583" status="INCOMING"><orgName>Massachusetts General Hospital</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Cao, Caroline" sort="Cao, Caroline" uniqKey="Cao C" first="Caroline" last="Cao">Caroline Cao</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-236007" status="INCOMING"><orgName>Ergonomics in Remote Environments Laboratory</orgName><orgName type="acronym">EREL</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-211712" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-211712" type="direct"><org type="institution" xml:id="struct-211712" status="VALID"><orgName>Wright State University [Dayton]</orgName><desc><address><addrLine>3640 Colonel Glenn Hwy, Dayton, OH 45435</addrLine><country key="US"></country></address><ref type="url">http://www.wright.edu/</ref></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">HAL</idno><idno type="RBID">Hal:hal-00957676</idno><idno type="halId">hal-00957676</idno><idno type="halUri">https://hal.archives-ouvertes.fr/hal-00957676</idno><idno type="url">https://hal.archives-ouvertes.fr/hal-00957676</idno><idno type="doi">10.1007/s00464-014-3538-2</idno><date when="2014-10-01">2014-10-01</date><idno type="wicri:Area/Hal/Corpus">000561</idno><idno type="wicri:Area/Hal/Curation">000561</idno><idno type="wicri:Area/Hal/Checkpoint">000053</idno><idno type="wicri:doubleKey">0930-2794:2014:Chellali A:validation:of:the</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Validation of the VBLaST Peg Transfer Task: A First Step toward an Alternate Training Standard</title><author><name sortKey="Chellali, Amine" sort="Chellali, Amine" uniqKey="Chellali A" first="Amine" last="Chellali">Amine Chellali</name><affiliation wicri:level="1"><hal:affiliation type="researchteam" xml:id="struct-398500" status="INCOMING"><orgName>IRA2</orgName><desc><address><country key="FR"></country></address></desc><listRelation><relation active="#struct-143247" type="direct"></relation><relation active="#struct-93105" type="indirect"></relation><relation active="#struct-236008" type="direct"></relation><relation active="#struct-356838" type="indirect"></relation></listRelation><tutelles><tutelle active="#struct-143247" type="direct"><org type="laboratory" xml:id="struct-143247" status="VALID"><orgName>Informatique, Biologie Intégrative et Systèmes Complexes</orgName><orgName type="acronym">IBISC</orgName><desc><address><addrLine>40 rue du Pelvoux, Courcouronnes ; 91020 Evry Cedex</addrLine><country key="FR"></country></address><ref type="url">http://www.ibisc.univ-evry.fr/</ref></desc><listRelation><relation active="#struct-93105" type="direct"></relation></listRelation></org></tutelle><tutelle active="#struct-93105" type="indirect"><org type="institution" xml:id="struct-93105" status="VALID"><orgName>Université d'Evry-Val d'Essonne</orgName><desc><address><addrLine>Boulevard François Mitterrand 91025 Evry Cedex</addrLine><country key="FR"></country></address><ref type="url">http://www.univ-evry.fr/fr/index.html</ref></desc></org></tutelle><tutelle active="#struct-236008" type="direct"><org type="laboratory" xml:id="struct-236008" status="INCOMING"><orgName>Interactive Surgical Systems Laboratory</orgName><orgName type="acronym">ISSyL</orgName><desc><address><addrLine>Cambridge</addrLine><country key="US"></country></address><ref type="url">http://www.issyl-lab.org</ref></desc><listRelation><relation active="#struct-356838" type="direct"></relation></listRelation></org></tutelle><tutelle active="#struct-356838" type="indirect"><org type="institution" xml:id="struct-356838" status="INCOMING"><orgName>Cambridge Health Alliance - Harvard Medical School</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Zhang, Likun" sort="Zhang, Likun" uniqKey="Zhang L" first="Likun" last="Zhang">Likun Zhang</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-236007" status="INCOMING"><orgName>Ergonomics in Remote Environments Laboratory</orgName><orgName type="acronym">EREL</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-211712" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-211712" type="direct"><org type="institution" xml:id="struct-211712" status="VALID"><orgName>Wright State University [Dayton]</orgName><desc><address><addrLine>3640 Colonel Glenn Hwy, Dayton, OH 45435</addrLine><country key="US"></country></address><ref type="url">http://www.wright.edu/</ref></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Sankaranarayanan, Ganesh" sort="Sankaranarayanan, Ganesh" uniqKey="Sankaranarayanan G" first="Ganesh" last="Sankaranarayanan">Ganesh Sankaranarayanan</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246732" status="INCOMING"><orgName>Center for Modeling, Simulation and Imaging in Medicine</orgName><orgName type="acronym">CMSIM</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-364148" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-364148" type="direct"><org type="institution" xml:id="struct-364148" status="INCOMING"><orgName>Rensselaer Polytechnic Institute</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Arikatla, V S" sort="Arikatla, V S" uniqKey="Arikatla V" first="V. S." last="Arikatla">V. S. Arikatla</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246732" status="INCOMING"><orgName>Center for Modeling, Simulation and Imaging in Medicine</orgName><orgName type="acronym">CMSIM</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-364148" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-364148" type="direct"><org type="institution" xml:id="struct-364148" status="INCOMING"><orgName>Rensselaer Polytechnic Institute</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Ahn, Woojin" sort="Ahn, Woojin" uniqKey="Ahn W" first="Woojin" last="Ahn">Woojin Ahn</name><affiliation wicri:level="1"><hal:affiliation type="researchteam" xml:id="struct-398501" status="INCOMING"><orgName>Center for Modeling, Simulation and Imaging in Medicine</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-246733" type="direct"></relation><relation active="#struct-364148" type="indirect"></relation></listRelation><tutelles><tutelle active="#struct-246733" type="direct"><org type="laboratory" xml:id="struct-246733" status="INCOMING"><orgName>Center for Modeling, Simulation and Imaging in Medicine</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-364148" type="direct"></relation></listRelation></org></tutelle><tutelle active="#struct-364148" type="indirect"><org type="institution" xml:id="struct-364148" status="INCOMING"><orgName>Rensselaer Polytechnic Institute</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Derevianko, A P" sort="Derevianko, A P" uniqKey="Derevianko A" first="A. P." last="Derevianko">A. P. Derevianko</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246734" status="INCOMING"><orgName>Department of Surgery</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-374583" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-374583" type="direct"><org type="institution" xml:id="struct-374583" status="INCOMING"><orgName>Massachusetts General Hospital</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Schwaitzberg, Steven D" sort="Schwaitzberg, Steven D" uniqKey="Schwaitzberg S" first="Steven D." last="Schwaitzberg">Steven D. Schwaitzberg</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-236008" status="INCOMING"><orgName>Interactive Surgical Systems Laboratory</orgName><orgName type="acronym">ISSyL</orgName><desc><address><addrLine>Cambridge</addrLine><country key="US"></country></address><ref type="url">http://www.issyl-lab.org</ref></desc><listRelation><relation active="#struct-356838" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-356838" type="direct"><org type="institution" xml:id="struct-356838" status="INCOMING"><orgName>Cambridge Health Alliance - Harvard Medical School</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Jones, Daniel B" sort="Jones, Daniel B" uniqKey="Jones D" first="Daniel B." last="Jones">Daniel B. Jones</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246735" status="INCOMING"><orgName>Department of Surgery</orgName><desc><address><country key="FR"></country></address></desc><listRelation><relation active="#struct-305601" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-305601" type="direct"><org type="institution" xml:id="struct-305601" status="INCOMING"><orgName>Beth Israel Deaconess Medical Center, Harvard Medical School</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Demoya, Marc" sort="Demoya, Marc" uniqKey="Demoya M" first="Marc" last="Demoya">Marc Demoya</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-246734" status="INCOMING"><orgName>Department of Surgery</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-374583" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-374583" type="direct"><org type="institution" xml:id="struct-374583" status="INCOMING"><orgName>Massachusetts General Hospital</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author><author><name sortKey="Cao, Caroline" sort="Cao, Caroline" uniqKey="Cao C" first="Caroline" last="Cao">Caroline Cao</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-236007" status="INCOMING"><orgName>Ergonomics in Remote Environments Laboratory</orgName><orgName type="acronym">EREL</orgName><desc><address><country key="US"></country></address></desc><listRelation><relation active="#struct-211712" type="direct"></relation></listRelation><tutelles><tutelle active="#struct-211712" type="direct"><org type="institution" xml:id="struct-211712" status="VALID"><orgName>Wright State University [Dayton]</orgName><desc><address><addrLine>3640 Colonel Glenn Hwy, Dayton, OH 45435</addrLine><country key="US"></country></address><ref type="url">http://www.wright.edu/</ref></desc></org></tutelle></tutelles></hal:affiliation><country>États-Unis</country></affiliation></author></analytic><idno type="DOI">10.1007/s00464-014-3538-2</idno><series><title level="j">Surgical Endoscopy</title><idno type="ISSN">0930-2794</idno><imprint><date type="datePub">2014-10-01</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="mix" xml:lang="en"><term>Fundamentals of Laparoscopic Skills (FLS)</term><term>Surgical training</term><term>Virtual Basic Laparoscopic Surgical Trainer (VBLaST)</term><term>force feedback</term><term>virtual reality (VR)</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: The FLS trainer lacks objective and automated assessments of laparoscopic performance and requires a large supply of relatively expensive consumables. Virtual reality simulation has a great potential as a training and assessment tool of laparoscopic skills and can overcome some limitations of the FLS trainer. This study was carried out to assess the value of our Virtual Basic Laparoscopic Surgical Trainer (VBLaST©) in the peg transfer task compared to the FLS trainer and its ability to differentiate performance between novice, intermediate and expert groups. Methods: Thirty subjects were divided into three groups: novices (PGY1-2, n = 10), intermediates (PGY3-4, n=10), and experts (PGY5, surgical fellows and attendings, n = 10). All subjects performed ten trials of the peg transfer task on each simulator. Assessment of laparoscopic performance was based on FLS scoring while a questionnaire was used for subjective evaluation. Results: The performance scores in the two simulators were correlated, though subjects performed significantly better in the FLS trainer. Experts performed better than novices only on the FLS trainer while no significant differences were observed between the other groups. Moreover, a significant learning effect was found on both trainers, with a greater improvement of performance on the VBLaST©. Finally, 82.6% of the subjects preferred the FLS over the VBLaST© for surgical training which could be attributed to the novelty of the VR technology and existing deficiencies of the user interface for the VBLaST©. Conclusion: This study demonstrated that the VBLaST© reproduced faithfully some aspects of the FLS peg transfer task (such as color, size and shape of the peg board, etc.) while other aspects require additional development. Future improvement of the user interface and haptic feedback will enhance the value of the system as an alternative to the FLS as the standard training tool for laparoscopic surgery skills.</div></front></TEI></HAL><PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Validation of the VBLaST Peg Transfer Task: A First Step towards an Alternate Training Standard</title><author><name sortKey="Chellali, A" sort="Chellali, A" uniqKey="Chellali A" first="A." last="Chellali">A. Chellali</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Department of Computing Engineering, University of Evry, IBISC Laboratory, Evry, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Computing Engineering, University of Evry, IBISC Laboratory, Evry</wicri:regionArea><placeName><region type="région">Île-de-France</region><settlement type="city">Évry (Essonne)</settlement></placeName></affiliation></author><author><name sortKey="Zhang, L" sort="Zhang, L" uniqKey="Zhang L" first="L." last="Zhang">L. Zhang</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Mechanical Engineering, Tufts University, Medford, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Mechanical Engineering, Tufts University, Medford, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Sankaranarayanan, G" sort="Sankaranarayanan, G" uniqKey="Sankaranarayanan G" first="G." last="Sankaranarayanan">G. Sankaranarayanan</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Arikatla, V S" sort="Arikatla, V S" uniqKey="Arikatla V" first="V. S." last="Arikatla">V. S. Arikatla</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Ahn, W" sort="Ahn, W" uniqKey="Ahn W" first="W." last="Ahn">W. Ahn</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Derevianko, A" sort="Derevianko, A" uniqKey="Derevianko A" first="A." last="Derevianko">A. Derevianko</name><affiliation wicri:level="2"><nlm:aff id="A5">Department of Surgery, Massachusetts General Hospital, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Massachusetts General Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Schwaitzberg, S D" sort="Schwaitzberg, S D" uniqKey="Schwaitzberg S" first="S. D." last="Schwaitzberg">S. D. Schwaitzberg</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Jones, D B" sort="Jones, D B" uniqKey="Jones D" first="D. B." last="Jones">D. B. Jones</name><affiliation wicri:level="2"><nlm:aff id="A6">Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Demoya, M" sort="Demoya, M" uniqKey="Demoya M" first="M." last="Demoya">M. Demoya</name><affiliation wicri:level="2"><nlm:aff id="A5">Department of Surgery, Massachusetts General Hospital, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Massachusetts General Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Cao, C G L" sort="Cao, C G L" uniqKey="Cao C" first="C. G. L." last="Cao">C. G. L. Cao</name><affiliation wicri:level="2"><nlm:aff id="A7">Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24771197</idno><idno type="pmc">4189970</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189970</idno><idno type="RBID">PMC:4189970</idno><idno type="doi">10.1007/s00464-014-3538-2</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001A24</idno><idno type="wicri:Area/Pmc/Curation">001A24</idno><idno type="wicri:Area/Pmc/Checkpoint">000833</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">000675</idno><idno type="wicri:Area/PubMed/Curation">000675</idno><idno type="wicri:Area/PubMed/Checkpoint">000485</idno><idno type="wicri:Area/Ncbi/Merge">002F28</idno><idno type="wicri:Area/Ncbi/Curation">002F28</idno><idno type="wicri:Area/Ncbi/Checkpoint">002F28</idno><idno type="wicri:doubleKey">0930-2794:2014:Chellali A:validation:of:the</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Validation of the VBLaST Peg Transfer Task: A First Step towards an Alternate Training Standard</title><author><name sortKey="Chellali, A" sort="Chellali, A" uniqKey="Chellali A" first="A." last="Chellali">A. Chellali</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">Department of Computing Engineering, University of Evry, IBISC Laboratory, Evry, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Computing Engineering, University of Evry, IBISC Laboratory, Evry</wicri:regionArea><placeName><region type="région">Île-de-France</region><settlement type="city">Évry (Essonne)</settlement></placeName></affiliation></author><author><name sortKey="Zhang, L" sort="Zhang, L" uniqKey="Zhang L" first="L." last="Zhang">L. Zhang</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Mechanical Engineering, Tufts University, Medford, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Mechanical Engineering, Tufts University, Medford, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Sankaranarayanan, G" sort="Sankaranarayanan, G" uniqKey="Sankaranarayanan G" first="G." last="Sankaranarayanan">G. Sankaranarayanan</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Arikatla, V S" sort="Arikatla, V S" uniqKey="Arikatla V" first="V. S." last="Arikatla">V. S. Arikatla</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Ahn, W" sort="Ahn, W" uniqKey="Ahn W" first="W." last="Ahn">W. Ahn</name><affiliation><nlm:aff id="A4">Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute</nlm:aff><wicri:noCountry code="subfield">Rensselaer Polytechnic Institute</wicri:noCountry></affiliation></author><author><name sortKey="Derevianko, A" sort="Derevianko, A" uniqKey="Derevianko A" first="A." last="Derevianko">A. Derevianko</name><affiliation wicri:level="2"><nlm:aff id="A5">Department of Surgery, Massachusetts General Hospital, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Massachusetts General Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Schwaitzberg, S D" sort="Schwaitzberg, S D" uniqKey="Schwaitzberg S" first="S. D." last="Schwaitzberg">S. D. Schwaitzberg</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Jones, D B" sort="Jones, D B" uniqKey="Jones D" first="D. B." last="Jones">D. B. Jones</name><affiliation wicri:level="2"><nlm:aff id="A6">Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Demoya, M" sort="Demoya, M" uniqKey="Demoya M" first="M." last="Demoya">M. Demoya</name><affiliation wicri:level="2"><nlm:aff id="A5">Department of Surgery, Massachusetts General Hospital, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Massachusetts General Hospital, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Cao, C G L" sort="Cao, C G L" uniqKey="Cao C" first="C. G. L." last="Cao">C. G. L. Cao</name><affiliation wicri:level="2"><nlm:aff id="A7">Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author></analytic><series><title level="j">Surgical endoscopy</title><idno type="ISSN">0930-2794</idno><idno type="eISSN">1432-2218</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Clinical Competence</term><term>Computer Simulation</term><term>Feedback</term><term>Female</term><term>Humans</term><term>Laparoscopy (education)</term><term>Male</term><term>Middle Aged</term><term>User-Computer Interface</term></keywords><keywords scheme="MESH" qualifier="education" xml:lang="en"><term>Laparoscopy</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Clinical Competence</term><term>Computer Simulation</term><term>Feedback</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>User-Computer Interface</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">The FLS trainer lacks objective and automated assessments of laparoscopic performance and requires a large supply of relatively expensive consumables. Virtual reality simulation has a great potential as a training and assessment tool of laparoscopic skills and can overcome some limitations of the FLS trainer. This study was carried out to assess the value of our Virtual Basic Laparoscopic Surgical Trainer (VBLaST©) in the peg transfer task compared to the FLS trainer and its ability to differentiate performance between novice, intermediate and expert groups.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Thirty subjects were divided into three groups: novices (PGY1-2, n = 10), intermediates (PGY3-4, n=10), and experts (PGY5, surgical fellows and attendings, n = 10). All subjects performed ten trials of the peg transfer task on each simulator. Assessment of laparoscopic performance was based on FLS scoring while a questionnaire was used for subjective evaluation.</p></sec><sec id="S3"><title>Results</title><p id="P3">The performance scores in the two simulators were correlated, though subjects performed significantly better in the FLS trainer. Experts performed better than novices only on the FLS trainer while no significant differences were observed between the other groups. Moreover, a significant learning effect was found on both trainers, with a greater improvement of performance on the VBLaST©. Finally, 82.6% of the subjects preferred the FLS over the VBLaST© for surgical training which could be attributed to the novelty of the VR technology and existing deficiencies of the user interface for the VBLaST©.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">This study demonstrated that the VBLaST© reproduced faithfully some aspects of the FLS peg transfer task (such as color, size and shape of the peg board, etc.) while other aspects require additional development. Future improvement of the user interface and haptic feedback will enhance the value of the system as an alternative to the FLS as the standard training tool for laparoscopic surgery skills.</p></sec></div></front></TEI></PMC></double></record>Pour manipuler ce document sous Unix (Dilib)
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