VR study exp 2 phase I and II data analysis

The aim of this study was to compare a virtual reality (VR) training program to a standard surgical guide training program (SG) for a simulated tibial shaft intramedullary nail (IMN) procedure. 20-first and second-year novice medical students were recruited and randomized to VR(n=10) and SG(n=10) training groups. Participants were then evaluated by a blinded attending surgeon performing simulated tibial IMN procedure immediately after training (Phase-1) and again 2-weeks later (Phase-2) using a procedure-specific checklist and 5-point global assessment scale. Phase-1 was completed by all participants; 17 participants returned to complete Phase-2 VR(n=8), SG(n=9). Global assessment scores were significantly higher for VR than SG groups in all categories and in aggregate (p=0.003), as were the percentage of steps completed correctly (63% vs. 25%, p=0.002). The VR group showed a higher percent improvement in global assessment scores between Phase-1 and Phase-2 of the experiment, which was significant for knowledge of instruments (50% vs. 11%, p=0.01). All statistical analysis was performed using GraphPad Prism Statistics / Data Analysis software (GraphPad Software Inc., La Jolla, CA) using non-parametric tests. The performance of the Surgical Guide and Virtual Reality groups were compared using the Mann-Whitney U test for each section of the Global Assessment 5-Point Rating Scale and Fischer’s Exact test for the number of students able to complete each step of the Procedure-Specific Checklist. A p-value < 0.05 was considered statistically significant.本研究旨在对比虚拟现实（Virtual Reality, VR）培训方案与标准手术导板（Surgical Guide, SG）培训方案在模拟胫骨干髓内钉（tibial shaft intramedullary nail, IMN）手术中的应用效果。研究招募20名一二年级医学新手学生，随机分为VR组（n=10）与SG组（n=10）。培训结束后，由盲态主治医师分别于即刻（阶段1）及2周后（阶段2），采用手术专用核查清单与5分制全局评估量表，对参与者完成的模拟胫骨髓内钉手术操作进行评估。阶段1所有参与者均完成测试；共有17名参与者返回完成阶段2测试，其中VR组8人，SG组9人。VR组在全局评估的所有维度及总分上的得分均显著高于SG组（p=0.003），正确完成手术步骤的占比亦显著高于SG组（63% vs. 25%，p=0.002）。相较于SG组，VR组在阶段1与阶段2间的全局评估得分提升幅度更高，其中器械知识维度的提升差异具有统计学意义（50% vs. 11%，p=0.01）。所有统计分析均采用GraphPad Prism统计与数据分析软件（GraphPad Software Inc.，美国加利福尼亚州拉霍亚市）完成，分析方法为非参数检验：针对5分制全局评估量表的各维度，采用曼-惠特尼U检验对比两组表现；针对手术专用核查清单中各步骤的完成人数，采用费希尔精确检验。本研究将p值<0.05作为统计学显著性判定标准。