title: Does box model training improve surgical dexterity and economy of movement during virtual reality laparoscopy? A randomised trial.
abstract: OBJECTIVE
  Laparoscopic box model trainers have been used in training curricula for a long time, however data on their impact on skills acquisition is still limited. Our aim was to validate a low cost box model trainer as a tool for the training of skills relevant to laparoscopic surgery.
  
  
  METHODS
  Randomised, controlled trial (Canadian Task Force Classification I).
  
  
  METHODS
  University Hospital.
  
  
  RESULTS
  Sixteen gynaecologic residents with limited laparoscopic experience were randomised to a group that received a structured box model training curriculum, and a control group. Performance before and after the training was assessed in a virtual reality laparoscopic trainer (LapSim and was based on objective parameters, registered by the computer system (time, error, and economy of motion scores). Group A showed significantly greater improvement in all performance parameters compared with the control group: economy of movement (p=0.001), time (p=0.001) and tissue damage (p=0.036), confirming the positive impact of box-trainer curriculum on laparoscopic skills acquisition.
  
  
  CONCLUSIONS
  Structured laparoscopic skill training on a low cost box model trainer improves performance as assessed using the VR system. Trainees who used the box model trainer showed significant improvement compared to the control group. Box model trainers are valid tools for laparoscopic skills training and should be implemented in the comprehensive training curricula in gynaecology.
authors.affiliation: Department of Gynaecology and Obstetrics, Copenhagen University, Gentofte Hospital, Denmark. clevin@get2net.dk
authors.forename: Lotte
authors.initials: L
authors.lastname: Clevin
authors.forename: Teodor P
authors.initials: TP
authors.lastname: Grantcharov
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008297:Male