Dry lab practice leads to improved laparoscopic performance in the operating room.
BACKGROUND
Research has demonstrated that practice in surgical simulators leads to improved performance in that simulator. Our hypothesis is that skills acquired in simulators are transferable to the operating room.


METHODS
Twenty-three laparoscopically naïve surgical interns performed two standardized tasks in a simulator: pegboard transfer and intracorporeal knot tying. Performance was measured using a validated scoring system. On the same day as this initial assessment, subjects were videotaped performing two tasks in a live porcine model: running the small bowel and intracorporeal knot tying. Performance in the porcine model was measured using a modified version of a validated skills assessment tool by two blinded experts. Following a 6-wk proficiency-based dry lab laparoscopic training course, task performance was re-evaluated. No interval live operative laparoscopic experience occurred between the first and second assessment.


RESULTS
After training, mean pegboard transfer scores increased from 118.7 to 181.8 (theoretical maximum = 300; P < 0.01). Dry lab knot tying scores increased from 294.7 to 459.0 (theoretical maximum = 600, P < 0.01). In the porcine model, scores for the bowel running task increased from 8.5 to 13.5 (maximum score = 20 for both porcine tasks, P < 0.01). Knot tying scores increased from 7.3 to 14.3 (P < 0.01).


CONCLUSIONS
Practice in a simulator leads to improved performance in that simulator and in a live operative model. We believe that this is evidence that laparoscopic skills developed in a dry laboratory setting are transferable to the operating room.
Stelzer
Marie K
MK
Department of Surgery; University of Wisconsin, Madison, Wisconsin 53792, USA. mk.stelzer@hosp.wisc.edu
Abdel
Matthew P
MP
Sloan
Michael P
MP
Gould
Jon C
JC
D002983:Clinical Competence; D003162:Competency-Based Education; D003198:Computer Simulation; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000592:standards*; D009873:Operating Rooms; D013518:Surgery, Plastic / Q000193:education; D013514:Surgical Procedures, Operative / Q000592:standards; D013536:Suture Techniques / Q000592:standards