title: [Does the incorporation of a virtual simulator improve abilities in endoscopic surgery acquired with an inanimate simulator?].
abstract: BACKGROUND
  The carrying out of training courses in surgical endoscopy for surgeons in training centres, is becoming more common. In addition to adequately planning activities, simulation systems are used to improve learning and monitor progression. Inanimate models and virtual reality programs increase psychomotor skills and assessment of performance. In this work we tried to improve our training program, basically in training boxes by introducing a virtual simulator.
  
  
  METHODS
  Seventeen surgical residents, with a basic training were chosen as the control group. Two additional groups were established, group A: with 6 hours of training with inanimate simulator. Group B: the same training system plus 4h of practice with LapSim. Exercises in the endotrainer and virtual simulator with moving-replacing objects, cutting and suturing-knotting were planned. End-point was time (mean with 95% confidence interval) in every exercise in box trainer, before and after the training period.
  
  
  RESULTS
  Movement exercises: Time in control group was 223.6s, A:103.7s, and B:89.9s (Control vs. A, P < 0.05). Cutting exercises: Time in control group was 317.7s, group A: 232.8s and in the B: 163.6s, (Control vs. B, P < 0.05). In the suture/knot exercise everyone was able to carry out a stitch after the training period. Time in control group was 518.4s, in group A: 309.4s, P < 0.05, and in B:189.5s (Control vs. A, P < 0.05).
  
  
  CONCLUSIONS
  Training in inanimate boxes was able to improve the skills of students, particularly for moving and suture/knots. The incorporation of a virtual simulator increased the learning capabilities, mainly in cutting exercises.
authors.affiliation: Centro de Entrenamiento Quirúrgico y Transferencia Tecnológica (CEQTt), Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Central de Asturias, Oviedo, España. joseignacio.rodriguez@sespa.princast.es
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Rodríguez García
authors.forename: Estrella
authors.initials: E
authors.lastname: Turienzo Santos
authors.forename: Juan José
authors.initials: JJ
authors.lastname: González González
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004724:Endoscopy / Q000193:education* / Q000592:standards*; D006801:Humans