Augmented reality telementoring (ART) platform: a randomized controlled trial to assess the efficacy of a new surgical education technology

Abstract

Laparoscopic skills training has evolved over recent years. However, conveying a mentor’s directions using conventional methods, without realistic on-screen visual cues, can be difficult and confusing. To facilitate laparoscopic skill transference, an augmented reality telementoring (ART) platform was designed to overlay the instruments of a mentor onto the trainee’s laparoscopic monitor. The aim of this study was to compare the effectiveness of this new teaching modality to traditional methods in novices performing an intracorporeal suturing task. Nineteen pre-medical and medical students were randomized into traditional mentoring (n = 9) and ART (n = 10) groups for a laparoscopic suturing and knot-tying task. Subjects received either traditional mentoring or ART for 1 h on the validated fundamentals of laparoscopic surgery intracorporeal suturing task. Tasks for suturing were recorded and scored for time and errors. Results were analyzed using means, standard deviation, power regression analysis, correlation coefficient, analysis of variance, and student’s t test. Using Wright’s cumulative average model (Y = aX ^b) the learning curve slope was significantly steeper, demonstrating faster skill acquisition, for the ART group (b = −0.567, r ² = 0.92) than the control group (b = −0.453, r ² = 0.74). At the end of 10 repetitions or 1 h of practice, the ART group was faster versus traditional (mean 167.4 vs. 242.4 s, p = 0.014). The ART group also had fewer fails (8) than the traditional group (13). The ART Platform may be a more effective training technique in teaching laparoscopic skills to novices compared to traditional methods. ART conferred a shorter learning curve, which was more pronounced in the first 4 trials. ART reduced the number of failed attempts and resulted in faster suture times by the end of the training session. ART may be a more effective training tool in laparoscopic surgical training for complex tasks than traditional methods.