title: Novices outperform experienced laparoscopists on virtual reality laparoscopy simulator.
abstract: OBJECTIVE
  Virtual reality has been poorly studied among gynecologic surgeons. The aim of this study was to evaluate whether performance on the Minimally Invasive Surgery Trainer-Virtual Reality (MIST-VR) laparoscopic trainer reflects laparoscopic experience among gynecologic surgeons and trainees.
  
  
  METHODS
  Twenty-six medical students, residents, and attending gynecologic surgeons completed a MIST-VR training program. A new simulated task was then presented to each participant, who repeated the task until proficiency was reached.
  
  
  RESULTS
  Attending physicians performed poorly when compared with medical students, requiring more than twice the number of attempts to reach proficiency (Mann-Whitney P<0.01). Among medical students and residents, there was an association between years of live laparoscopy experience and poor simulator performance (Spearman r P=0.01).
  
  
  CONCLUSIONS
  Increased operating room experience and age were associated with worsening simulator performance. Several potential explanations for this trend are discussed, including lack of tactile and contextual feedback. Caution should be exercised when considering current virtual reality simulator technology as a measure of experience or ability among gynecologic surgeons.
authors.affiliation: Department of OB/GYN, Baystate Medical Center, Springfield, Massachusetts, USA. andrew.mooore@nhs.org
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Moore
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Grow
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Bush
authors.forename: Neal E
authors.initials: NE
authors.lastname: Seymour
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006176:Gynecology / Q000193:education; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D008875:Middle Aged; D013337:Students, Medical; D014584:User-Computer Interface