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Systematic review

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Effect of Playing Video Games on Laparoscopic Skills Performance: A Systematic Review.

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Journal Journal of endourology / Endourological Society
Year 2016
Links Pubmed DOI

This article includes 5 Primary studies 5 Primary studies (5 references)

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Introduction The advances in both video games and minimally invasive surgery have allowed many to consider the potential positive relationship between the two. This review aims to evaluate outcomes of studies that investigated the correlation between video game skills and performance in laparoscopic surgery. Methods A systematic search was conducted on PubMed / Medline and EMBASE databases for the MeSH terms and keywords including "video games and laparoscopy", "computer games and laparoscopy", "Xbox and laparoscopy", "Nintendo Wii and laparoscopy" and "Playstation and laparoscopy". Cohort, case reports, letters, editorials, bulletins and reviews were excluded. Studies in English, with task performance as primary outcome, were included. The search period for this review was 1950 to December 2014. Results 57 abstracts were identified. 4 of these were found to be duplicates. 32 were found to be non relevant to the research question. Overall, 21 full texts were assessed; 16 were excluded according to the MERSQI quality assessment criteria. The five studies included in this review were randomised controlled trials. Playing video games was found to reduce error in two studies (p 0.002 and p 0.045). However for the same studies several other metrics assessed were not significantly different between the control and intervention group. One study showed a decrease in the time for the group that played video games (p 0.037) for one out of two laparoscopic tasks performed. However, in the same study when the groups were reversed (initial control group became intervention and vice versa) a difference was not demonstrated (p for peg transfer 1 - 0.465, p for cobra robe - 0.185). Finally, two further studies found no statistical difference between the game playing group and the control group's performance. CONCLUSION: There is a very limited amount of evidence to support that the use of video games enhances surgical simulation performance.

Systematic review

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State of the evidence on simulation-based training for laparoscopic surgery: a systematic review.

Journal Annals of surgery
Year 2013
Links Pubmed DOI

This article includes 219 Primary studies 219 Primary studies (219 references)

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OBJECTIVE: Summarize the outcomes and best practices of simulation training for laparoscopic surgery. BACKGROUND: Simulation-based training for laparoscopic surgery has become a mainstay of surgical training. Much new evidence has accrued since previous reviews were published. METHODS: We systematically searched the literature through May 2011 for studies evaluating simulation, in comparison with no intervention or an alternate training activity, for training health professionals in laparoscopic surgery. Outcomes were classified as satisfaction, skills (in a test setting) of time (to perform the task), process (eg, performance rating), product (eg, knot strength), and behaviors when caring for patients. We used random effects to pool effect sizes. RESULTS: From 10,903 articles screened, we identified 219 eligible studies enrolling 7138 trainees, including 91 (42%) randomized trials. For comparisons with no intervention (n = 151 studies), pooled effect size (ES) favored simulation for outcomes of knowledge (1.18; N = 9 studies), skills time (1.13; N = 89), skills process (1.23; N = 114), skills product (1.09; N = 7), behavior time (1.15; N = 7), behavior process (1.22; N = 15), and patient effects (1.28; N = 1), all P < 0.05. When compared with nonsimulation instruction (n = 3 studies), results significantly favored simulation for outcomes of skills time (ES, 0.75) and skills process (ES, 0.54). Comparisons between different simulation interventions (n = 79 studies) clarified best practices. For example, in comparison with virtual reality, box trainers have similar effects for process skills outcomes and seem to be superior for outcomes of satisfaction and skills time. CONCLUSIONS: Simulation-based laparoscopic surgery training of health professionals has large benefits when compared with no intervention and is moderately more effective than nonsimulation instruction.

Systematic review

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Role of video games in improving health-related outcomes: a systematic review.

Journal American journal of preventive medicine
Year 2012
Links Pubmed DOI PubMed Central

This article is included in 1 Structured summary of systematic reviews 38 Structured summaries of systematic reviews (1 reference)

This article includes 38 Primary studies 38 Primary studies (38 references)

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CONTEXT: Video games represent a multibillion-dollar industry in the U.S. Although video gaming has been associated with many negative health consequences, it also may be useful for therapeutic purposes. The goal of this study was to determine whether video games may be useful in improving health outcomes. EVIDENCE ACQUISITION: Literature searches were performed in February 2010 in six databases: the Center on Media and Child Health Database of Research, MEDLINE, CINAHL, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials. Reference lists were hand-searched to identify additional studies. Only RCTs that tested the effect of video games on a positive, clinically relevant health consequence were included. Study selection criteria were strictly defined and applied by two researchers working independently. Study background information (e.g., location, funding source); sample data (e.g., number of study participants, demographics); intervention and control details; outcomes data; and quality measures were abstracted independently by two researchers. EVIDENCE SYNTHESIS: Of 1452 articles retrieved using the current search strategy, 38 met all criteria for inclusion. Eligible studies used video games to provide physical therapy, psychological therapy, improved disease self-management, health education, distraction from discomfort, increased physical activity, and skills training for clinicians. Among the 38 studies, a total of 195 health outcomes were examined. Video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. Study quality was generally poor; for example, two thirds (66%) of studies had follow-up periods of <12 weeks, and only 11% of studies blinded researchers. CONCLUSIONS: There is potential promise for video games to improve health outcomes, particularly in the areas of psychological therapy and physical therapy. RCTs with appropriate rigor will help build evidence in this emerging area.

Systematic review

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Systematic review of serious games for medical education and surgical skills training.

Journal The British journal of surgery
Year 2012
Links Pubmed DOI RxForChange

This article includes 17 Primary studies 17 Primary studies (17 references)

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BACKGROUND: The application of digital games for training medical professionals is on the rise. So-called 'serious' games form training tools that provide a challenging simulated environment, ideal for future surgical training. Ultimately, serious games are directed at reducing medical error and subsequent healthcare costs. The aim was to review current serious games for training medical professionals and to evaluate the validity testing of such games. METHODS: PubMed, Embase, the Cochrane Database of Systematic Reviews, PsychInfo and CINAHL were searched using predefined inclusion criteria for available studies up to April 2012. The primary endpoint was validation according to current criteria. RESULTS: A total of 25 articles were identified, describing a total of 30 serious games. The games were divided into two categories: those developed for specific educational purposes (17) and commercial games also useful for developing skills relevant to medical personnel (13). Pooling of data was not performed owing to the heterogeneity of study designs and serious games. Six serious games were identified that had a process of validation. Of these six, three games were developed for team training in critical care and triage, and three were commercially available games applied to train laparoscopic psychomotor skills. None of the serious games had completed a full validation process for the purpose of use. CONCLUSION: Blended and interactive learning by means of serious games may be applied to train both technical and non-technical skills relevant to the surgical field. Games developed or used for this purpose need validation before integration into surgical teaching curricula.

Systematic review

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Systematic review of predictors of surgical performance.

Authors Maan ZN , Maan IN , Darzi AW , Aggarwal R
Journal The British journal of surgery
Year 2012
Links Pubmed DOI

This article includes 26 Primary studies 26 Primary studies (26 references)

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BACKGROUND: Selection criteria for surgical training are not scientifically proven. There is a need to define which attributes predict future surgical performance. The aim of this study was to examine the predictive value of specific attributes that impact on surgical performance. METHODS: All studies assessing the predictive power of specified attributes with regard to outcome measures of surgical performance in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Educational Resources Information Centre databases, and bibliographies of selected articles from 1950 to November 2010 were considered for inclusion by two independent reviewers. Information on study identifiers, participant characteristics, predictors assessed, evaluation methods for predictors, outcome measures, results and statistical analysis was collected. Quality assessment was carried out using the Hayden criteria. RESULTS: Visual-spatial perception correlated with both subjective and objective assessments of surgical performance, including rate of skill acquisition. Visual-spatial perception did not correlate with operative ability in experts, although it did with operative ability at the end of a training programme. Psychomotor aptitude, assessed collectively, correlated with rate of skill acquisition. Academic achievement predicted completion of a training programme and passing end-of-training examinations, but did not predict clinical performance during the training programme. CONCLUSION: Intermediate- and high-level visual-spatial perception, as well as psychomotor aptitude, can be used as criteria for assessing candidates for surgical training. Academic achievement is an effective predictor of successful completion of training programmes and should continue to form part of the assessment of surgical candidates.

Systematic review

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Video games and surgical ability: a literature review.

Authors Lynch J , Aughwane P , Hammond TM
Journal Journal of surgical education
Year 2010
Links Pubmed DOI

This article includes 12 Primary studies 12 Primary studies (12 references)

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OBJECTIVE: Surgical training is rapidly evolving because of reduced training hours and the reduction of training opportunities due to patient safety concerns. There is a popular conception that video game usage might be linked to improved operating ability especially those techniques involving endoscopic modalities. If true this might suggest future directions for training. METHODS: A search was made of the MEDLINE databases for the MeSH term, "Video Games," combined with the terms "Surgical Procedures, Operative," "Endoscopy," "Robotics," "Education," "Learning," "Simulators," "Computer Simulation," "Psychomotor Performance," and "Surgery, Computer-Assisted,"encompassing all journal articles before November 2009. References of articles were searched for further studies. RESULTS: Twelve relevant journal articles were discovered. Video game usage has been studied in relationship to laparoscopic, gastrointestinal endoscopic, endovascular, and robotic surgery. CONCLUSIONS: Video game users acquire endoscopic but not robotic techniques quicker, and training on video games appears to improve performance.

Systematic review

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Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review.

Journal Medical teacher
Year 2005
Links Pubmed DOI

This article is included in 1 Broad synthesis 167 Broad syntheses (1 reference)

This article includes 167 Primary studies 167 Primary studies (167 references)

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REVIEW DATE: 1969 to 2003, 34 years. BACKGROUND AND CONTEXT: Simulations are now in widespread use in medical education and medical personnel evaluation. Outcomes research on the use and effectiveness of simulation technology in medical education is scattered, inconsistent and varies widely in methodological rigor and substantive focus. OBJECTIVES: Review and synthesize existing evidence in educational science that addresses the question, 'What are the features and uses of high-fidelity medical simulations that lead to most effective learning?'. SEARCH STRATEGY: The search covered five literature databases (ERIC, MEDLINE, PsycINFO, Web of Science and Timelit) and employed 91 single search terms and concepts and their Boolean combinations. Hand searching, Internet searches and attention to the 'grey literature' were also used. The aim was to perform the most thorough literature search possible of peer-reviewed publications and reports in the unpublished literature that have been judged for academic quality. INCLUSION AND EXCLUSION CRITERIA: Four screening criteria were used to reduce the initial pool of 670 journal articles to a focused set of 109 studies: (a) elimination of review articles in favor of empirical studies; (b) use of a simulator as an educational assessment or intervention with learner outcomes measured quantitatively; (c) comparative research, either experimental or quasi-experimental; and (d) research that involves simulation as an educational intervention. DATA EXTRACTION: Data were extracted systematically from the 109 eligible journal articles by independent coders. Each coder used a standardized data extraction protocol. DATA SYNTHESIS: Qualitative data synthesis and tabular presentation of research methods and outcomes were used. Heterogeneity of research designs, educational interventions, outcome measures and timeframe precluded data synthesis using meta-analysis. HEADLINE RESULTS: Coding accuracy for features of the journal articles is high. The extant quality of the published research is generally weak. The weight of the best available evidence suggests that high-fidelity medical simulations facilitate learning under the right conditions. These include the following: providing feedback--51 (47%) journal articles reported that educational feedback is the most important feature of simulation-based medical education; repetitive practice--43 (39%) journal articles identified repetitive practice as a key feature involving the use of high-fidelity simulations in medical education; curriculum integration--27 (25%) journal articles cited integration of simulation-based exercises into the standard medical school or postgraduate educational curriculum as an essential feature of their effective use; range of difficulty level--15 (14%) journal articles address the importance of the range of task difficulty level as an important variable in simulation-based medical education; multiple learning strategies--11 (10%) journal articles identified the adaptability of high-fidelity simulations to multiple learning strategies as an important factor in their educational effectiveness; capture clinical variation--11 (10%) journal articles cited simulators that capture a wide variety of clinical conditions as more useful than those with a narrow range; controlled environment--10 (9%) journal articles emphasized the importance of using high-fidelity simulations in a controlled environment where learners can make, detect and correct errors without adverse consequences; individualized learning--10 (9%) journal articles highlighted the importance of having reproducible, standardized educational experiences where learners are active participants, not passive bystanders; defined outcomes--seven (6%) journal articles cited the importance of having clearly stated goals with tangible outcome measures that will more likely lead to learners mastering skills; simulator validity--four (3%) journal articles provided evidence for the direct correlation of simulation validity with effective learning. CONCLUSIONS: While research in this field needs improvement in terms of rigor and quality, high-fidelity medical simulations are educationally effective and simulation-based education complements medical education in patient care settings.