Abstract：
OBJECTIVE: We previously designed and validated a virtual reality-based simulator to help train novices in ultrasound-guided needling skills necessary for safe and competent ultrasound-guided regional anaesthesia. This study was designed to compare the performance and error rates of novices trained by a human faculty aided with the assistance of this virtual reality simulator (virtual reality-assisted training), versus novices trained wholly by humans (conventional training).
METHODS: In this single centre, randomised controlled study, we used a standardised teaching protocol, rigorous blinding, iterative training of assessors, and validated global rating scale and composite error score checklists to assess skills learning of novice participants.
RESULTS: We recruited 45 novices and scored 270 assessments of performance and error rates. Inter-rater correlation coefficient of reliability of scoring between assessors for the global rating scale was 0.84 (95%CI 0.68-0.92) and for the composite error score checklist was 0.87 (95%CI 0.73-0.93). After adjustment for age, sex, Depression, Anxiety and Stress-21, and baseline score, there was no statistical difference for virtual reality-assisted training compared to conventional training in final global rating score (average treatment effect -3.30 (95%CI-13.07-6.48), p = 0.51) or in the final composite error score (average treatment effect 1.14 (95%CI -0.60-2.88), p = 0.20). Realism in the virtual reality simulator was similar to real-life when measured by the Presence Questionnaire, all components p > 0.79; and task workload assessed by the NASA-Task Load Index was not statistically different between groups, average treatment effect 5.02 (95%CI -3.51-13.54), p = 0.25. Results were achieved in the virtual reality-assisted group with half the human faculty involvement.
CONCLUSIONS: Novices trained using a hybrid, virtual reality-assisted teaching program showed no superiority to novices trained using a conventional teaching program, but with less burden on teaching resources.
METHODS: In this single centre, randomised controlled study, we used a standardised teaching protocol, rigorous blinding, iterative training of assessors, and validated global rating scale and composite error score checklists to assess skills learning of novice participants.
RESULTS: We recruited 45 novices and scored 270 assessments of performance and error rates. Inter-rater correlation coefficient of reliability of scoring between assessors for the global rating scale was 0.84 (95%CI 0.68-0.92) and for the composite error score checklist was 0.87 (95%CI 0.73-0.93). After adjustment for age, sex, Depression, Anxiety and Stress-21, and baseline score, there was no statistical difference for virtual reality-assisted training compared to conventional training in final global rating score (average treatment effect -3.30 (95%CI-13.07-6.48), p = 0.51) or in the final composite error score (average treatment effect 1.14 (95%CI -0.60-2.88), p = 0.20). Realism in the virtual reality simulator was similar to real-life when measured by the Presence Questionnaire, all components p > 0.79; and task workload assessed by the NASA-Task Load Index was not statistically different between groups, average treatment effect 5.02 (95%CI -3.51-13.54), p = 0.25. Results were achieved in the virtual reality-assisted group with half the human faculty involvement.
CONCLUSIONS: Novices trained using a hybrid, virtual reality-assisted teaching program showed no superiority to novices trained using a conventional teaching program, but with less burden on teaching resources.
摘要：
目的：我们之前设计并验证了一种基于虚拟现实的模拟器，以帮助培训新手在超声引导下的针刺技能，这是安全和胜任的超声引导区域麻醉所必需的。这项研究旨在比较由人类教师在虚拟现实模拟器（虚拟现实辅助培训）的帮助下训练的新手的表现和错误率，与完全由人类训练的新手（常规训练）相比。
方法：在这个单一中心，随机对照研究，我们使用了标准化的教学协议，严格的致盲,评估员的迭代培训，以及经过验证的全球评分量表和综合错误评分检查表，以评估新手参与者的技能学习。
结果：我们招募了45名新手，对绩效和错误率进行了270次评估。全球评分表评估者之间评分可靠性的评分者间相关系数为0.84（95CI0.68-0.92），综合错误评分清单为0.87（95CI0.73-0.93）。调整后的年龄，性别,抑郁症,焦虑和压力-21和基线评分，与传统训练相比，虚拟现实辅助训练在最终总体评分方面没有统计学差异(平均治疗效果-3.30(95CI-13.07-6.48)，p=0.51）或最终综合误差评分（平均治疗效果1.14（95CI-0.60-2.88），p=0.20)。虚拟现实模拟器中的现实主义与现实生活相似，通过存在问卷进行测量，所有成分p>0.79；NASA任务负荷指数评估的任务工作量在组间没有统计学差异，平均治疗效果5.02（95CI-3.51-13.54），p=0.25。在虚拟现实辅助组中取得了成果，其中一半的教师参与。
结论：使用混合体训练的新手，虚拟现实辅助教学计划与使用常规教学计划培训的新手相比没有优势，但对教学资源的负担较小。
方法：在这个单一中心，随机对照研究，我们使用了标准化的教学协议，严格的致盲,评估员的迭代培训，以及经过验证的全球评分量表和综合错误评分检查表，以评估新手参与者的技能学习。
结果：我们招募了45名新手，对绩效和错误率进行了270次评估。全球评分表评估者之间评分可靠性的评分者间相关系数为0.84（95CI0.68-0.92），综合错误评分清单为0.87（95CI0.73-0.93）。调整后的年龄，性别,抑郁症,焦虑和压力-21和基线评分，与传统训练相比，虚拟现实辅助训练在最终总体评分方面没有统计学差异(平均治疗效果-3.30(95CI-13.07-6.48)，p=0.51）或最终综合误差评分（平均治疗效果1.14（95CI-0.60-2.88），p=0.20)。虚拟现实模拟器中的现实主义与现实生活相似，通过存在问卷进行测量，所有成分p>0.79；NASA任务负荷指数评估的任务工作量在组间没有统计学差异，平均治疗效果5.02（95CI-3.51-13.54），p=0.25。在虚拟现实辅助组中取得了成果，其中一半的教师参与。
结论：使用混合体训练的新手，虚拟现实辅助教学计划与使用常规教学计划培训的新手相比没有优势，但对教学资源的负担较小。
