OR fire virtual training simulator: design and face validity.

BACKGROUND: The Virtual Electrosurgical Skill Trainer is a tool for training surgeons the safe operation of electrosurgery tools in both open and minimally invasive surgery. This training includes a dedicated team-training module that focuses on operating room (OR) fire prevention and response. The module was developed to allow trainees, practicing surgeons, anesthesiologist, and nurses to interact with a virtual OR environment, which includes anesthesia apparatus, electrosurgical equipment, a virtual patient, and a fire extinguisher. Wearing a head-mounted display, participants must correctly identify the "fire triangle" elements and then successfully contain an OR fire. Within these virtual reality scenarios, trainees learn to react appropriately to the simulated emergency. A study targeted at establishing the face validity of the virtual OR fire simulator was undertaken at the 2015 Society of American Gastrointestinal and Endoscopic Surgeons conference. METHODS: Forty-nine subjects with varying experience participated in this Institutional Review Board-approved study. The subjects were asked to complete the OR fire training/prevention sequence in the VEST simulator. Subjects were then asked to answer a subjective preference questionnaire consisting of sixteen questions, focused on the usefulness and fidelity of the simulator. RESULTS: On a 5-point scale, 12 of 13 questions were rated at a mean of 3 or greater (92%). Five questions were rated above 4 (38%), particularly those focusing on the simulator effectiveness and its usefulness in OR fire safety training. A total of 33 of the 49 participants (67%) chose the virtual OR fire trainer over the traditional training methods such as a textbook or an animal model. CONCLUSIONS: Training for OR fire emergencies in fully immersive VR environments, such as the VEST trainer, may be the ideal training modality. The face validity of the OR fire training module of the VEST simulator was successfully established on many aspects of the simulation.

The effect of stress on learning in surgical skill acquisition.

BACKGROUND: An excessive level of stress and anxiety in medical education can have a negative impact on learning. In particular, the interaction between attending surgeons and trainees in the operating room could induce stress on trainees that is counterproductive, especially if the teaching style or feedback is unduly harsh or critical. AIM: To characterize the effects of stress resulting from attending-trainee interaction during surgical skill acquisition. METHODS: Forty medical students learned to perform the FLS pattern-cutting task for the first time in one of four scenarios. In the control condition, no mentor was present. In the three experimental conditions, participants were observed, encouraged, or criticized by an expert surgeon. RESULTS: Task performance, as well as physiological and subjective indicators of stress, were measured. Taking both speed and accuracy into account, participants who were criticized performed the worst on the task, and those who were encouraged performed best. Physiological and subjective measures indicated that the criticized participants experienced the highest level of stress and anxiety. CONCLUSION: Even though providing constructive criticism to trainees is inevitable during the course of teaching, an exceedingly critical and negative mentoring style by attending physicians could be detrimental to trainees' acquisition of surgical skills.

Segregation from direction differences in dynamic random-dot stimuli.

Previous research has shown that a field of random dots in which each dot alternates between a slow and a fast speed, can give rise to the percept of two superimposed sheets of moving dots when the alternations are out of phase or asynchronous with each other [Vis. Res. 35 (1995) 1691]. Under those conditions, observers can discriminate changes in the slow speed independent of changes in the fast speed. The present study investigated whether such motion-based segregation could result when dots alternated between two different directions. Three observers viewed a variety of displays containing two directions of motion, one upward and one oblique, with the task of discriminating small trial-to-trial changes in the direction of the upward component. The oblique direction component also changed direction from trial-to-trial. The field of dots either alternated synchronously (all dots moved in the same direction and switched to the other direction simultaneously) or asynchronously. Results showed that when the dots alternated synchronously between the directions, observers' direction discrimination performance was generally poor. However, when dots switched directions asynchronously, direction discrimination was only slightly elevated in comparison to that produced by a field of dots all moving in a single direction. Additional experiments demonstrated that this performance was not due to judging the global direction of the random-dot display. Thus the visual system had to segregate the stimulus into its component directions before integrating to arrive at the motion signal to be discriminated. It is concluded that for displays comprising elements that alternate between different directions, local direction signals can be used by the human visual system to effectively segregate a display so long as both direction signals are present simultaneously.