title: Effect of virtual reality training on laparoscopic surgery: randomised controlled trial.
abstract: OBJECTIVE
  To assess the effect of virtual reality training on an actual laparoscopic operation.
  
  
  METHODS
  Prospective randomised controlled and blinded trial.
  
  
  METHODS
  Seven gynaecological departments in the Zeeland region of Denmark.
  
  
  METHODS
  24 first and second year registrars specialising in gynaecology and obstetrics.
  
  
  METHODS
  Proficiency based virtual reality simulator training in laparoscopic salpingectomy and standard clinical education (controls).
  
  
  METHODS
  The main outcome measure was technical performance assessed by two independent observers blinded to trainee and training status using a previously validated general and task specific rating scale. The secondary outcome measure was operation time in minutes.
  
  
  RESULTS
  The simulator trained group (n=11) reached a median total score of 33 points (interquartile range 32-36 points), equivalent to the experience gained after 20-50 laparoscopic procedures, whereas the control group (n=10) reached a median total score of 23 (22-27) points, equivalent to the experience gained from fewer than five procedures (P<0.001). The median total operation time in the simulator trained group was 12 minutes (interquartile range 10-14 minutes) and in the control group was 24 (20-29) minutes (P<0.001). The observers' inter-rater agreement was 0.79.
  
  
  CONCLUSIONS
  Skills in laparoscopic surgery can be increased in a clinically relevant manner using proficiency based virtual reality simulator training. The performance level of novices was increased to that of intermediately experienced laparoscopists and operation time was halved. Simulator training should be considered before trainees carry out laparoscopic procedures.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00311792.
authors.affiliation: Department of Gynecology, Juliane Marie Centre for Children, Women and Reproduction, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100 OE, Copenhagen, Denmark. crl@dadlnet.dk [corrected]
authors.forename: Christian R
authors.initials: CR
authors.lastname: Larsen
authors.forename: Jette L
authors.initials: JL
authors.lastname: Soerensen
authors.forename: Teodor P
authors.initials: TP
authors.lastname: Grantcharov
authors.forename: Torur
authors.initials: T
authors.lastname: Dalsgaard
authors.forename: Lars
authors.initials: L
authors.lastname: Schouenborg
authors.forename: Christian
authors.initials: C
authors.lastname: Ottosen
authors.forename: Torben V
authors.initials: TV
authors.lastname: Schroeder
authors.forename: Bent S
authors.initials: BS
authors.lastname: Ottesen
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D003718:Denmark; D004503:Education, Medical, Graduate; D005260:Female; D013502:General Surgery / Q000193:education*; D006176:Gynecology / Q000193:education*; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D008297:Male; D011446:Prospective Studies; D013663:Teaching / Q000379:methods; D013997:Time Factors