Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies.
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.
Ahlberg
Gunnar
G
Department of Surgery, Karolinska University Hospital, SE-171 76, Sweden. gunnar.ahlberg@karolinska.se
Enochsson
Lars
L
Gallagher
Anthony G
AG
Hedman
Leif
L
Hogman
Christian
C
McClusky
David A
DA
Ramel
Stig
S
Smith
C Daniel
CD
Arvidsson
Dag
D
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