Traditional box training prepares students for examinations but can it fully prepare them for the real situations they’ll face in surgery? Some medical schools, including Yale, believe students are better prepared for the operating room when VR simulation training supplements box training. We talk with Dr. Hulda Einarsdottir who makes the case for using VR simulation to prepare students for success in their training and FLS exams.

The limitations of box training

The FLS exam is the standardized measure of surgical competence. It is used to determine whether a resident possesses the cognitive knowledge and manual skills to perform laparoscopic surgery. Although students can acquire enough proficiency to pass the FLS using box training, it has its limitations. Here are five ways VR surgical simulation supplements box training to help improve students’ surgical skills:

1 – VR simulation training provides objective data analysis
A box trainer gives you the experience of using a camera and instruments but it can’t tell you that you have failed a training exercise because your hand movements were too inconsistent or efficient. This is the objective data analysis that only VR simulation training can provide. Each exercise can be recorded with detailed metrics, statistics, and a video of the performance, providing both immediate and long-term skill development feedback.

VR simulation provides students with conditions that prepare them to be better surgeons in the OR.

2 – VR simulation develops proficiency in key surgical skills that box trainers cannot.
Good traction-counter traction skills with surgical instruments is critical in laparoscopic surgery. This skill involves pulling the instruments in opposite directions to expose the organs, vessels, or nerves. It is a difficult skill to accomplish. Historically, students learned these techniques under the guidance of a surgeon because a box trainer cannot teach these skills. With VR simulation, however, students can learn these key skills without supervision.

3 – VR training provides a more realistic surgical environment.
The surgical conditions presented by VR simulation training are tighter, more realistic, and more like actual surgery. The simple box trainer cameras may be more comfortable for the students to use, but VR training delivers a more realistic surgical experience. Training with VR simulators provides students with an environment that prepares them to be better surgeons in the OR.

 4 – Real-time evaluation of surgical technique without supervision.
We use our hands differently to how surgeons use their hands in surgery. For example, if you are right-handed, you focus solely on your right hand for everyday tasks. However, surgeons must learn to use both hands at the same time. When residents begin training, they have problems with their non-dominant hand and tend to drift out of camera view. A box trainer can’t tell you this happening, whereas a VR simulator can. Our Surgical Science LapSim provides students with constant hawk-like evaluation of their grasper movements. Residents training without VR simulation need a surgeon telling them that their hand is out of view or warning them to not let their arm drift. .

5 – The LapSim program offers an FLS practice test.
The Surgical Science LapSim offers an FLS practice test. The teacher monitoring is built into the simulation program and can be used to practice for the FLS exam. It is a valuable tool that students can use to prepare for the exam.

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