title: Proficiency-based laparoscopic simulator training leads to improved operating room skill that is resistant to decay.
abstract: The aim of this study was to assess skill retention in the operating room following completion of a proficiency-based laparoscopic skills curriculum. Novices (n = 15) were randomized to a control and a training group that practiced to proficiency on the Fundamentals of Laparoscopic Surgery suturing model. The performance of both groups was assessed on the simulator and on a live porcine laparoscopic Nissen fundoplication model at training completion (posttest) and 5 months later (retention test). Training to proficiency required 4.7 +/-1.2 hours and 41 +/- 10 repetitions. Trained participants outperformed controls, and their performance deteriorated slightly between posttests and retention tests on the simulator (505 +/- 22 vs 462 +/- 50, respectively; P < .05) but not in operating room (263 +/- 138 vs 279 +/- 88, respectively; P = .38). Proficiency-based simulator training results in durable improvement in operative skill of trainees even in the absence of practice for up to 5 months. Minute simulator performance changes do not translate to the operating room.
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA. Dimitrios.Stefanidis@carolinashealthcare.org
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stefanidis
authors.forename: Christina
authors.initials: C
authors.lastname: Acker
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
mesh_terms: D000328:Adult; D000818:Animals; D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D013552:Swine