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Results for “simulation training”

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At least 217 records · Page 12Linked to original sources
PubMed1998

A vascular catheterization simulator for training and treatment planning.

We have developed a working prototype of an augmented reality based vascular catheterization simulator. The simulator is called daVinci, and provides the interventional radiologists with a "hands on, user friendly, image based environment to augment training, enhance pretreatment planning and design interventional products and devices. daVinci is based on computational modeling of human anatomical images and provides the user with capabilities for realtime simulated navigation of catheters in both 2-D and 3-D modeled vessels. In addition, multiplaner CT, MRI and anatomical data sets are incorporated into the simulator to enhance the understanding of anatomical relationships associated with vascular catheterization procedures. The current prototype is designed for peripheral vascular applications. Additional systems are currently being considered for both interventional neuroradiology and cardiology.

Angiography↗
PubMed2005

Interactive real-time simulation of an endoscopic polyp removal.

The paper describes methods used for an interactive real-time training simulation of an endoscopic procedure: the removal of a colon polyp. Biomechanical simulation of the polyp is provided by a Finite Element approach. A combination of animation and simulation models the flexing, retraction and deployment of the used instrument, a wire sling. The presented method enables a training simulation of the surgery, based on the endoscopic simulator EndoSim.

Colonic Polyps↗
PubMed2026

Structured robotic colorectal training in a non-tertiary NHS hospital: a 502-case consecutive cohort implementation study.

Robotic-assisted colorectal surgery has expanded rapidly across NHS practice in the UK. Structured unit-wide training pathways are essential for safe technology adoption, yet published outcome data from non-tertiary hospitals remain limited. This study describes the implementation and feasibility of a unit-wide robotic colorectal program at a high-volume non-tertiary hospital, reporting outcomes across 502 consecutive resections performed by eight consultant surgeons and presenting these in the context of nationally published benchmarks. A retrospective cohort study of 502 consecutive robotic colorectal resections performed at York Teaching Hospital between May 2022 and December 2025. Eight consultant surgeons (A-H) participated in a structured four-phase training pathway incorporating simulation training, proctored cases, complexity-based case progression, and formal credentialing. Primary outcomes were 30-day mortality, unplanned return to theatre (RTT), and anastomotic leak (AL). Anastomotic leak was calculated using only patients who underwent anastomosis as the denominator. Procedure-stratified and individual surgeon outcomes with 95% confidence intervals were reported. Risk-adjusted cumulative sum (RA-CUSUM) analysis was performed to evaluate learning curves. Outcomes are presented descriptively alongside nationally published reference data; no formal statistical comparison against national benchmarks was performed. 502 robotic colorectal resections were performed. Mean patient age was 70.0 ± 11.3 years; 58.4% were male. Median ASA grade was III. The indication was malignancy in 89.2% of cases. Length of stay was non-normally distributed and is therefore reported using median and interquartile range in the revised analysis. Key outcomes: - 30-day mortality: 1.0% (5/502; 95% CI 0.4-2.3%) - Unplanned return to theatre (RTT): 5.2% (26/502; 95% CI 3.6-7.5%) - Anastomotic leak (AL): 3.3% (15/450; 95% CI 2.0-5.5%; denominator = patients with anastomosis) - 30-day unplanned readmission: 5.0% (25/502; 95% CI 3.4-7.2%) - Conversion to open surgery: 3.6% (18/502; 95% CI 2.3-5.6%) - Lymph node yield ≥12: 91.3% of cancer resections - R0 resection rate: 95.1% of cancer resections All primary outcomes fell within or below the published reference ranges used for descriptive context. RA-CUSUM trajectories were heterogeneous: no surgeon crossed the predefined upper control limit, but several curves showed later upward movement. Accordingly, the analysis is interpreted as safety surveillance rather than evidence of uniform performance improvement. RA-CUSUM monitoring showed that no surgeon crossed the predefined upper control limit; however, heterogeneous trajectories precluded a claim of uniform performance improvement.

Humans↗
PubMed2006

Lessons from the surgical experience with simulators: incorporation into training and utilization in determining competency.

Simulation technology in laparoscopic surgery has developed in response to a need to teach fundamental surgical skills in a safe environment. The skill set needed was defined carefully according to the classic educational model of needs assessment. Once defined, the skills were modeled in a simulator. The recognition that a simulator need not have high fidelity to achieve significant educational value was important in keeping costs reasonably low. Intrinsic to an effective simulation program is a set of metrics or measurements of performance. These metrics provide motivation for the student and allow comparison among students. Once shown to be reliable and valid, the simulator metrics can be used to set reasonable goals and standards for certification. Although simulators permit verification of learning, point simulation testing cannot by itself be used at present to ensure competence. Until the predictive value of these tests has been validated further, competence still needs to be determined by expert assessment of observed performance in real cases and by measurable outcome variables from real procedures. Simulation training is most beneficial when incorporated into a curriculum that teaches the accompanying knowledge and judgment essential for safe practice of the skills taught in the simulator. The FLS program distributed by the Society of American Gastrointestinal and Endoscopic Surgeons and the American College of Surgeons is an example of a carefully planned and validated program that incorporates these principles in laparoscopic surgery education. The lessons learned from development of the FLS program can be useful in designing a similar program for flexible gastrointestinal endoscopy.

Clinical Competence↗
PubMed2003

Low- to high-fidelity simulation - a continuum of medical education?

CONTEXT: Changes in medical training and culture have reduced the acceptability of the traditional apprenticeship style training in medicine and influenced the growth of clinical skills training. Simulation is an educational technique that allows interactive, and at times immersive, activity by recreating all or part of a clinical experience without exposing patients to the associated risks. The number and range of commercially available technologies used in simulation for education of health care professionals is growing exponentially. These range from simple part-task training models to highly sophisticated computer driven models. AIM: This paper will review the range of currently available simulators and the educational processes that underpin simulation training. The use of different levels of simulation in a continuum of training will be discussed. Although simulation is relatively new to medicine, simulators have been used extensively for training and assessment in many other domains, most notably the aviation industry. Some parallels and differences will be highlighted.

Clinical Competence↗
PubMed2001

Molecular adaptations in human skeletal muscle to endurance training under simulated hypoxic conditions.

This study was performed to explore changes in gene expression as a consequence of exercise training at two levels of intensity under normoxic and normobaric hypoxic conditions (corresponding to an altitude of 3,850 m). Four groups of human subjects trained five times a week for a total of 6 wk on a bicycle ergometer. Muscle biopsies were taken, and performance tests were carried out before and after the training period. Similar increases in maximal O(2) uptake (8.3-13.1%) and maximal power output (11.4-20.8%) were found in all groups. RT-PCR revealed elevated mRNA concentrations of the alpha-subunit of hypoxia-inducible factor 1 (HIF-1) after both high- (+82.4%) and low (+78.4%)-intensity training under hypoxic conditions. The mRNA of HIF-1alpha(736), a splice variant of HIF-1alpha newly detected in human skeletal muscle, was shown to be changed in a similar pattern as HIF-1alpha. Increased mRNA contents of myoglobin (+72.2%) and vascular endothelial growth factor (+52.4%) were evoked only after high-intensity training in hypoxia. Augmented mRNA levels of oxidative enzymes, phosphofructokinase, and heat shock protein 70 were found after high-intensity training under both hypoxic and normoxic conditions. Our findings suggest that HIF-1 is specifically involved in the regulation of muscle adaptations after hypoxia training. Fine-tuning of the training response is recognized at the molecular level, and with less sensitivity also at the structural level, but not at global functional responses like maximal O(2) uptake or maximal power output.

Acyl-CoA Dehydrogenase↗
PubMed2006

Objective assessment of visuospatial and psychomotor ability and flow of residents and senior endoscopists in simulated gastroscopy.

BACKGROUND: Advanced medical simulators have predominantly been used to shorten the learning curve of endoscopy for medical students and young residents. Rarely have the effects of visuospatial ability and attitudes of intermediately experienced and experienced specialists been studied with regard to simulator training. The aim of this study was to assess the effects of visuospatial ability and attitude on performance in simulator training. METHODS: Eighteen surgical residents were included in the study. Prior to the simulated gastroscopy task, they performed a visuospatial test (the card rotation test). After the simulated gastroscopy task, they completed a questionnaire regarding flow experiences. Their results were compared with those of 11 expert endoscopists who performed the same tests. RESULTS: Total gastroscopy time was significantly shorter for the expert endoscopists compared to residents (2 min 11 sec, p = 0.003). There was also a trend of more mucosa inspected (p = 0.088) and higher efficiency of screening (p = 0.069) by the experts. The residents made fewer errors in the card rotation test than the expert endoscopists (2.5 +/- 0.8 vs 5.5 +/- 1.2, respectively; p = 0.034), and their visuospatial card rotation test results correlated better with their performance in the simulated gastroscopy. CONCLUSIONS: A virtual gastroscopy task presents more of an emotional as well as a psychomotoric challenge to intermediately experienced endoscopists than to senior experts. Our study demonstrates that these differences can be objectively assessed by the use of visuospatial ability tests, flowsheets, and an endoscopic simulator.

Adult↗
PubMed2005

Superiority of nonlinear mapping in decoding multiple single-unit neuronal spike trains: a simulation study.

One of the most important building blocks of the brain-machine interface (BMI) based on neuronal spike trains is the decoding algorithm, a computational method for the reconstruction of desired information from spike trains. Previous studies have reported that a simple linear filter is effective for this purpose and that no noteworthy gain is achieved from the use of nonlinear algorithms. In order to test this premise, we designed several decoding algorithms based on the linear filter, and two nonlinear mapping algorithms using multilayer perceptron (MLP) and support vector machine regression (SVR). Their performances were assessed using multiple neuronal spike trains generated by a biophysical neuron model and by a directional tuning model of the primary motor cortex. The performances of the nonlinear algorithms, in general, were superior. The advantages of using nonlinear algorithms were more profound for cases where false-positive/negative errors occurred in spike trains. When the MLPs were trained using trial-and-error, they often showed disappointing performance comparable to that of the linear filter. The nonlinear SVR showed the highest performance, and this may be due to the superiority of SVR in training and generalization.

Action Potentials↗
PubMed2004

Use of a virtual reality simulator for ureteroscopy training.

PURPOSE: Virtual reality surgical simulators may shorten operative time and reduce the potential for iatrogenic injury by providing training outside the operating room. We hypothesized that training on a virtual ureteroscopy (VU) simulator would allow novice endoscopists to overcome the initial learning curve before entering the operating room. MATERIALS AND METHODS: We evaluated 16 medical students on their ability to perform specific ureteroscopic tasks on a VU simulator. The students trained on the simulator for a total of 5 hours over multiple sessions using different training modules and then were retested on the initial module. Likewise, 16 urology residents with varying degrees of endoscopic experience were assessed on the same test module twice, without additional simulator training. RESULTS: The students improved task completion time from 17.4 to 8.7 minutes (p <0.05), while the residents performed the task in 7.6 minutes at baseline and 6.7 minutes at the second trial. Stratification of residents by years of urology training revealed that the mean completion time for the students after training did not differ statistically from that of first year residents who had performed a median of 14 clinical ureteroscopies. Furthermore, the subjective performance scores of the students were comparable to those of the first year residents. CONCLUSIONS: Novice medical students trained on a VU simulator improved task completion time by 50% after training, and performed comparably to residents who had completed nearly 1 year of urology training. VR training may allow beginning urology residents to shorten the initial learning curve associated with ureteroscopy training, although this hypothesis requires further validation.

Adult↗
PubMed2001

The performance of the standard rate turn (SRT) by student naval helicopter pilots.

BACKGROUND: During flight training, student naval helicopter pilots learn the use of flight instruments through a prescribed series of simulator training events. The training simulator is a 6-degrees-of-freedom, motion-based, high-fidelity instrument trainer. From the final basic instrument simulator flights of student pilots, we selected for evaluation and analysis their performance of the Standard Rate Turn (SRT), a routine flight maneuver. METHODS: The performance of the SRT was scored with air speed, altitude and heading average error from target values and standard deviations. These average errors and standard deviations were used in a Multiple Analysis of Variance (MANOVA) to evaluate the effects of three independent variables: 1) direction of turn (left vs. right), 2) degree of turn (180 vs. 360 degrees); and 3) segment of turn (roll-in, first 30 s, last 30 s, and roll-out of turn). RESULTS: Only the main effects of the three independent variables were significant; there were no significant interactions. This result greatly reduces the number of different conditions that should be scored separately for the evaluation of SRT performance. The results also showed that the magnitude of the heading and altitude errors at the beginning of the SRT correlated with the magnitude of the heading and altitude errors throughout the turn. This result suggests that for the turn to be well executed, it is important for it to begin with little error in these two response parameters. CONCLUSIONS: The observations reported here should be considered when establishing SRT performance norms and comparing student scores. Furthermore, it seems easier for pilots to maintain good performance than to correct poor performance.

Aircraft↗
PubMed1999

Demonstration of high-fidelity simulation team training for emergency medicine.

Emergency medicine (EM) presents many cognitive, social, and systems challenges to practitioners. Coordination and communication under stress between and among individuals and teams representing a number of disciplines are critical for optimal care of the patient. The specialty is characterized by uncertainty, complexity, rapidly shifting priorities, a dependence on teamwork, and elements common to other risky domains such as perioperative medicine and aviation. High-fidelity simulators have had a long tradition in aviation, and in the past few years have begun to have a significant impact in anesthesiology. A national, multicenter research program to document the costs of teamwork failures in EM and provide a remedy in the form of an Emergency Team Coordination Course has developed to the point that high-fidelity medical simulators will be added to the hands-on training portion of the course. This paper describes an evolving collaborative effort by members of the Center for Medical Simulation, the Harvard Emergency Medicine Division, and the MedTeams program to design, demonstrate, and refine a high-fidelity EM simulation course to improve EM clinician performance, increase patient safety, and decrease liability. The main objectives of the paper are: 1) to present detailed specifications of tools and techniques for high-fidelity medical simulation; 2) to share the results of a proof-of-concept EM simulation workshop introducing multiple mannequin/ three-patient scenarios; and 3) to focus on teamwork applications. The authors hope to engage the EM community in a wide-ranging discussion and handson exploration of these methods.

Clinical Competence↗