Presentation
SE4 - Integrative Surgical Simulation: Comparative Assessment of the Veterinary Assessment Laparoscopic Skills (VALS) and Fundamentals of Laparoscopic Surgery
SessionPoster Session 2
DescriptionAs part of Montana State University's mission as a land grant University there is a strong emphasis on agricultural, health and STEM fields. Without an affiliated academic medical center providing state of the art training to both medical and veterinary students has been a challenge. Both programs exist as a satellite program to recruit and retain physicians and veterinarians in our rural areas. As part of a brand-new core facility, the BioReD Hub is leveraging this lack of high-fidelity simulation training to offer both medical and veterinary students the opportunity to train and learn laparoscopic surgical skills whether for human or animal medicine.
The BioReD Hub’s vision is as a translatable research interface between the brain (neurobiology), cognition (neuroscience) and human behavior (human factors engineering). As part of the Montana State University’s core value of fostering innovation and exploration of novel ways to support our global and local communities, this interprofessional Hub of researchers from the Norm Asbjornson College of Engineering, Mark & Robyn Jones College of Nursing, Gianforte School of Computing, and many others use state-of-the-art instrumentation, research practices and innovative ideas to address biomedical systems engineering design, healthcare system improvement, and clinical practice advancement. This collaboration expands understanding and positively impacts lives and society, especially for Montanans.
The BioReD Hub is inclusive in its approach to include engineers, scientists, healthcare practitioners and other stakeholders to promote wellness by leveraging biomedical engineering and biological sciences to their fullest. The BioReD Hub leverages MSU’s access to front-line clinician expertise to translate solutions to frontier healthcare barriers and challenges. The BioReD seeks to engage rural and isolated populations that need access to the latest technologies that promote health and wellbeing. The BioReD Hub’s interdisciplinary vision is to promote both fundamental biomedical research advances at discipline interfaces for the rapid development of solutions for health and healthcare challenges.
The BioReD Hub's interdisciplinary instrumentation center uses state-of-the-art technology, research practices and innovative ideas to address biomedical systems engineering design, healthcare system improvement, and clinical practice advancement. Immersive, Multimodal, High-Fidelity Research instrumentation includes electroencephalogram (EEG), mobile fNIRS, eye-tracking glasses, multitouch drafting table, projection mapping, adult and pediatric patient simulators, and 3D prototyping technologies. The goals are to utilize this instrumentation to fundamentally understand multimodal responses, influences for sustained motivation, predict and design for direct action, and rapidly translate from bench to bedside.
This mixed methods study of the VALS and FLS simulator enables the comparison of the programs to better understand how to optimize training and spark interest for more to enter the field of medicine. The FLS and VALS Laparoscopic Trainer Systems are a device that facilitates the development of psychomotor skills and dexterity required during the performance of basic laparoscopic surgery. Akin to the FLS Program, the VALS is a laparoscopic skills training and assessment program available for veterinary surgeons. Diplomates of the American College of Veterinary Surgeons (ACVS), diplomates of the European College of Veterinary Surgeons (ECVS), and veterinarians currently in ACVS/ECVS-approved residency training programs are eligible to enroll in VALS. Also, Fellows and candidates of the Surgery Chapter in the Australian and New Zealand College of Veterinary Scientists (ANZCVS) can enroll. The goals of both programs are to gain advanced laparoscopic skills in a low-stress environment, gain laparoscopic manual skills including suturing, and become certified by the program.
Like FLS, VALS testing for certification can only occur at an approved VALS test center in good standing, by a trained VALS proctor, using standardized equipment. VALS testing is by appointment only, please contact your preferred VALS test center for an appointment. Unfortunately, there are a severe lack of training centers (only 2) and with so few certified veterinary laparoscopic surgeons in states that desperately need these skills like rural Montana where more livestock and ranch animals exist than human populace, access to testing/training centers is prohibiting growth. By leveraging the existing FLS program with the VALS program, the BioReD Hub team wants to make training (not testing at this juncture) more accessible to all those interested in these career fields and those currently enrolled as medical or veterinary student.
As a pilot study, ten (10) upper division trainees completed both the VALS and FLS peg transfer tasks in a crossover design. A Demographic questionnaire, electromyography (EMG) and task performance were used to compare the peg transfer simulation across the FLS and VALS peg transfer tasks. Performance was assessed via errors (dropped pegs) and task time. Bilateral EMG (iMotions 10.0 with Shimmer EMGs) of the neck and shoulders (i.e., sternocleidomastoid and upper deltoid muscles) were used to measure stress-associated tension, as well as startle responses. Lastly, Tobii Glasses 3 (Tobii, Denmark) were used to understand eye tracking patterns including fixations and saccades during task performance.
Overall the trainees performed better on the VALS peg transfer task with respect to errors (average VALS 2.3 vs. FLS 3.1) but required more time to complete VALS possibly due to its larger size and modified layout. Starte and fear EMG Responses were greatest during the first task iteration particularly spiking when attempting to recover a dropped peg. While not all eye-tracking data has been fully analyzed, fixations and saccades were akin to novice trainees (i.e., focusing solely on the immediate task versus experts looking ahead to next phase of task).
The BioReD Hub’s vision is as a translatable research interface between the brain (neurobiology), cognition (neuroscience) and human behavior (human factors engineering). As part of the Montana State University’s core value of fostering innovation and exploration of novel ways to support our global and local communities, this interprofessional Hub of researchers from the Norm Asbjornson College of Engineering, Mark & Robyn Jones College of Nursing, Gianforte School of Computing, and many others use state-of-the-art instrumentation, research practices and innovative ideas to address biomedical systems engineering design, healthcare system improvement, and clinical practice advancement. This collaboration expands understanding and positively impacts lives and society, especially for Montanans.
The BioReD Hub is inclusive in its approach to include engineers, scientists, healthcare practitioners and other stakeholders to promote wellness by leveraging biomedical engineering and biological sciences to their fullest. The BioReD Hub leverages MSU’s access to front-line clinician expertise to translate solutions to frontier healthcare barriers and challenges. The BioReD seeks to engage rural and isolated populations that need access to the latest technologies that promote health and wellbeing. The BioReD Hub’s interdisciplinary vision is to promote both fundamental biomedical research advances at discipline interfaces for the rapid development of solutions for health and healthcare challenges.
The BioReD Hub's interdisciplinary instrumentation center uses state-of-the-art technology, research practices and innovative ideas to address biomedical systems engineering design, healthcare system improvement, and clinical practice advancement. Immersive, Multimodal, High-Fidelity Research instrumentation includes electroencephalogram (EEG), mobile fNIRS, eye-tracking glasses, multitouch drafting table, projection mapping, adult and pediatric patient simulators, and 3D prototyping technologies. The goals are to utilize this instrumentation to fundamentally understand multimodal responses, influences for sustained motivation, predict and design for direct action, and rapidly translate from bench to bedside.
This mixed methods study of the VALS and FLS simulator enables the comparison of the programs to better understand how to optimize training and spark interest for more to enter the field of medicine. The FLS and VALS Laparoscopic Trainer Systems are a device that facilitates the development of psychomotor skills and dexterity required during the performance of basic laparoscopic surgery. Akin to the FLS Program, the VALS is a laparoscopic skills training and assessment program available for veterinary surgeons. Diplomates of the American College of Veterinary Surgeons (ACVS), diplomates of the European College of Veterinary Surgeons (ECVS), and veterinarians currently in ACVS/ECVS-approved residency training programs are eligible to enroll in VALS. Also, Fellows and candidates of the Surgery Chapter in the Australian and New Zealand College of Veterinary Scientists (ANZCVS) can enroll. The goals of both programs are to gain advanced laparoscopic skills in a low-stress environment, gain laparoscopic manual skills including suturing, and become certified by the program.
Like FLS, VALS testing for certification can only occur at an approved VALS test center in good standing, by a trained VALS proctor, using standardized equipment. VALS testing is by appointment only, please contact your preferred VALS test center for an appointment. Unfortunately, there are a severe lack of training centers (only 2) and with so few certified veterinary laparoscopic surgeons in states that desperately need these skills like rural Montana where more livestock and ranch animals exist than human populace, access to testing/training centers is prohibiting growth. By leveraging the existing FLS program with the VALS program, the BioReD Hub team wants to make training (not testing at this juncture) more accessible to all those interested in these career fields and those currently enrolled as medical or veterinary student.
As a pilot study, ten (10) upper division trainees completed both the VALS and FLS peg transfer tasks in a crossover design. A Demographic questionnaire, electromyography (EMG) and task performance were used to compare the peg transfer simulation across the FLS and VALS peg transfer tasks. Performance was assessed via errors (dropped pegs) and task time. Bilateral EMG (iMotions 10.0 with Shimmer EMGs) of the neck and shoulders (i.e., sternocleidomastoid and upper deltoid muscles) were used to measure stress-associated tension, as well as startle responses. Lastly, Tobii Glasses 3 (Tobii, Denmark) were used to understand eye tracking patterns including fixations and saccades during task performance.
Overall the trainees performed better on the VALS peg transfer task with respect to errors (average VALS 2.3 vs. FLS 3.1) but required more time to complete VALS possibly due to its larger size and modified layout. Starte and fear EMG Responses were greatest during the first task iteration particularly spiking when attempting to recover a dropped peg. While not all eye-tracking data has been fully analyzed, fixations and saccades were akin to novice trainees (i.e., focusing solely on the immediate task versus experts looking ahead to next phase of task).
Event Type
Poster Presentation
TimeTuesday, April 14:45pm - 6:15pm EDT
LocationFrontenac Foyer