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

doi:10.1016/j.amjsurg.2009.07.034

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 journal › Article › peer-review

78 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 language	English
Pages (from-to)	72-80
Number of pages	9
Journal	American Journal of Surgery
Volume	199
Issue number	1
DOIs	https://doi.org/10.1016/j.amjsurg.2009.07.034
State	Published - Jan 2010
Externally published	Yes

Keywords

Competency
Laparoscopic skills
Proficiency
Simulation
Targets
Virtual reality trainers

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10.1016/j.amjsurg.2009.07.034

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@article{378d3d36ed39420ba4b381e1d4f1478c,

title = "Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons",

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, Got{\"e}borg) 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.",

keywords = "Competency, Laparoscopic skills, Proficiency, Simulation, Targets, Virtual reality trainers",

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

note = "Funding Information: Supported by the Graduate Medical Education Innovations Fund of the University of Michigan Medical School. ",

year = "2010",

month = jan,

doi = "10.1016/j.amjsurg.2009.07.034",

language = "English",

volume = "199",

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journal = "American Journal of Surgery",

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AU - Gauger, Paul G.

AU - Hauge, Linnea S.

AU - Andreatta, Pamela B.

AU - Hamstra, Stanley J.

AU - Hillard, Miranda L.

AU - Arble, Eamonn P.

AU - Kasten, Steven J.

AU - Mullan, Patricia B.

AU - Cederna, Paul S.

AU - Minter, Rebecca M.

N1 - Funding Information: Supported by the Graduate Medical Education Innovations Fund of the University of Michigan Medical School.

PY - 2010/1

Y1 - 2010/1

N2 - 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.

AB - 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.

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KW - Laparoscopic skills

KW - Proficiency

KW - Simulation

KW - Targets

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

Abstract

Keywords

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