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

Paul G. Gauger*, Linnea S. Hauge, Pamela B. Andreatta, Stanley J. Hamstra, Miranda L. Hillard, Eamonn P. Arble, Steven J. Kasten, Patricia B. Mullan, Paul S. Cederna, Rebecca M. Minter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

77 Scopus citations

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.

Original languageEnglish
Pages (from-to)72-80
Number of pages9
JournalAmerican Journal of Surgery
Volume199
Issue number1
DOIs
StatePublished - Jan 2010
Externally publishedYes

Keywords

  • Competency
  • Laparoscopic skills
  • Proficiency
  • Simulation
  • Targets
  • Virtual reality trainers

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