Characterization of the Learning Plateau and the Learning Rate of the VBlaST PT © Simulator with a Kinematic Objective Performance Metric

Abstract

Gaining proficiency in laparoscopic surgery requires a considerable amount of practice. The VBLaST^© is a virtual reality simulator that can simulate the Fundamentals of Laparoscopic Surgery (FLS) tasks. It is equipped to compute and record scores automatically along with kinematic parameters such as path length, economy of motion, motion smoothness, etc. In this study the learning curve for the VBLaST PT^© simulator was characterized from both the computed numerical score and the path lengths of the left and right tools. From the learning curve, the learning plateau and the learning rate was also found for both parameters. A total of 6 subjects participated in the learning curve study that consisted of 15 sessions of 10 repetitions of the peg transfer task for a total of 150 repetitions in three weeks. Subjects performed better in terms of higher scores and shorter path lengths within the first practice session but improved their performance thereafter and achieved a stable plateau. Paired sampled t-test on the pre, post and retention tests showed significant learning retention for both metrics. Tool path length is a valid kinematic metric that can be used to assess the learning and retention of laparoscopic surgical skill along with the numerical score computed from completion time and errors.