Jan. 22, 1999 HERSHEY, PA-- Physicians at Penn State's College of Medicine are studying the optimal length of time it takes for physicians to use a human patient simulator. Simulators are being used more widely to simulate surgery for physicians. The process is often likened to flight simulation. It is a way to get experience without affecting patients.
"This simulator can measure a number of specific tasks. We have a very good idea now of the actual learning curve involved; this is the novel aspect of this study," explains W. Bosseau Murray, associate professor of anesthesia at Penn State's College of Medicine. "By measuring these specific tasks, we can tell the person exactly what areas need to be improved. We can quantify everything."
Murray and his team studied five individuals who were complete novices. They included medical students and others who had never touched surgical equipment. The subjects underwent 20-minute daily sessions working with the simulator. All subjects took part in approximately 13 to 17 sessions. Each subject's task in this virtual environment was to complete multiple phases of inserting a simulated needle through a target overlying a simulated hollow tube. Their overall scores plateaued after seven to 11 sessions.
This virtual reality test system is based on an innovative double-armed feedback trainer. A needle driver and forceps are attached to two Phantom haptic devices. Haptic devices produce force feedback which allows the sensation of touching a "virtual" object. A desktop computer is used to control the haptic element while a separate computer provides the graphic component. A dedicated software program measures six variables including the time to complete the task, accuracy, peak force applied, tissue damage and angle error.
"We wanted to use novices to help determine exactly how long it would take to reach peak levels. We were surprised it took as long as it did. Our next study will have physicians tested on the simulator. We believe this will greatly improve their surgical techniques and do so at a greatly reduced cost," states Murray.
In an earlier Penn State study, it was estimated that the average operation at The Milton S. Hershey Medical Center was about 3 to 4 hours, and about 1 hour of that time was used for teaching people such as physicians, anesthesiologists and nurses. Operating room time costs about $1,000 an hour, and there are approximately 13,500 operations annually. "When you consider we then spend about $13.5 million on teaching, spending about $50,000 on a simulator seems to make economic sense for hospitals," says Murray.
Murray and his colleagues presented their findings titled, "The Psychomotor Learning Curve with a Force Feedback Trainer: A Pilot Study," today at the annual meeting of the Society for Technology in Anesthesia in San Diego, Calif.
Murray is also an anesthesiologist at The Milton S. Hershey Medical Center which is part of the Penn State Geisinger Health System.
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