Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons

Am J Surg. 2010 Jan;199(1):72-80. doi: 10.1016/j.amjsurg.2009.07.034.

Abstract

Background: This study compares a laparoscopic skill training protocol without proficiency targets to the same protocol with explicit targets and notification of progress.

Methods: Fourteen surgery interns were randomized into 2 groups. The intervention group received task-specific proficiency criteria to guide practice. The control group did not. After training, participants were evaluated by blinded faculty during laparoscopic cholecystectomy.

Results: The control group met significantly fewer of the 7 LapSim (Surgical Science Sweden AB, Gotëborg) targets (mean = 1.14) than the intervention group (mean = 7.00; P = .001) and significantly fewer of the 5 video trainer targets (mean = .86) than the intervention group (mean = 5.00; P = .001). Ratings of depth perception, bimanual dexterity, efficiency, tissue handling, autonomy, and overall competence were higher for the intervention group. Effect sizes ranged from medium to large (.394-.981), indicating an impact of the proficiency-based training protocol.

Conclusions: Delineation of proficiency targets with reporting of progress improves interns' practice results, and appears to have a positive effect on their early operating room (OR) performance of laparoscopic cholecystectomy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Analysis of Variance
  • Cholecystectomy, Laparoscopic / education*
  • Clinical Competence*
  • Competency-Based Education
  • Computer Simulation
  • Education, Medical, Graduate / methods*
  • Female
  • Humans
  • Internship and Residency
  • Male
  • Probability
  • Prospective Studies
  • Reference Values
  • Risk Assessment
  • Task Performance and Analysis
  • United States
  • User-Computer Interface*
  • Video Recording