title: Virtual reality training leads to faster adaptation to the novel psychomotor restrictions encountered by laparoscopic surgeons.
abstract: BACKGROUND
  The fulcrum effect of the body wall on instrument handling poses a major obstacle to the mastery of instrument coordination for junior laparoscopic surgeons. This study evaluated three types of laparoscopic simulator training to assess their ability to promote the user's adaptation to the fulcrum effect.
  
  
  METHODS
  Thirty-two participants with no previous experience in laparoscopic surgery were randomly assigned to one of four groups representing different training conditions. One group was assigned to use a virtual reality simulator (MIST VR); two others were given a laparoscopic Z or U maze-tracking task. The control group received no training. Subjects were asked to perform a 2-min laparoscopic cutting task under normal laparoscopic imaging conditions first before and then after training.
  
  
  RESULTS
  In the test trial, subjects who trained on MIST VR made significantly more correct incisions (p < 0.0001) and fewer incorrect incisions (p < 0.0001).
  
  
  CONCLUSIONS
  Training on a virtual reality simulator such as MIST VR helps laparoscopic novices adapt to the fulcrum effect faster.
authors.affiliation: School of Psychology, The Queens' University of Belfast, David Keir Building, Malone Road, Belfast, BT7 1NN, Northern Ireland.
authors.forename: J A
authors.initials: JA
authors.lastname: Jordan
authors.forename: A G
authors.initials: AG
authors.lastname: Gallagher
authors.forename: J
authors.initials: J
authors.lastname: McGuigan
authors.forename: N
authors.initials: N
authors.lastname: McClure
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D018961:Educational Technology; D013502:General Surgery / Q000193:education*; D006801:Humans; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D011597:Psychomotor Performance