title: Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies.
abstract: BACKGROUND
  Virtual reality (VR) training has been shown previously to improve intraoperative performance during part of a laparoscopic cholecystectomy. The aim of this study was to assess the effect of proficiency-based VR training on the outcome of the first 10 entire cholecystectomies performed by novices.
  
  
  METHODS
  Thirteen laparoscopically inexperienced residents were randomized to either (1) VR training until a predefined expert level of performance was reached, or (2) the control group. Videotapes of each resident's first 10 procedures were reviewed independently in a blinded fashion and scored for predefined errors.
  
  
  RESULTS
  The VR-trained group consistently made significantly fewer errors (P = .0037). On the other hand, residents in the control group made, on average, 3 times as many errors and used 58% longer surgical time.
  
  
  CONCLUSIONS
  The results of this study show that training on the VR simulator to a level of proficiency significantly improves intraoperative performance during a resident's first 10 laparoscopic cholecystectomies.
authors.affiliation: Department of Surgery, Karolinska University Hospital, SE-171 76, Sweden. gunnar.ahlberg@karolinska.se
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ahlberg
authors.forename: Lars
authors.initials: L
authors.lastname: Enochsson
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Gallagher
authors.forename: Leif
authors.initials: L
authors.lastname: Hedman
authors.forename: Christian
authors.initials: C
authors.lastname: Hogman
authors.forename: David A
authors.initials: DA
authors.lastname: McClusky
authors.forename: Stig
authors.initials: S
authors.lastname: Ramel
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Smith
authors.forename: Dag
authors.initials: D
authors.lastname: Arvidsson
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D004521:Educational Measurement; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D019300:Medical Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008875:Middle Aged; D016544:Patient Simulation; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden; D014584:User-Computer Interface; D014741:Video Recording