Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons.
BACKGROUND
This study compares a laparoscopic skill training protocol without proficiency targets to the same protocol with explicit targets and notification of progress.


METHODS
Fourteen surgery interns were randomized into 2 groups. The intervention group received task-specific proficiency criteria to guide practice. The control group did not. After training, participants were evaluated by blinded faculty during laparoscopic cholecystectomy.


RESULTS
The control group met significantly fewer of the 7 LapSim (Surgical Science Sweden AB, Gotëborg) targets (mean = 1.14) than the intervention group (mean = 7.00; P = .001) and significantly fewer of the 5 video trainer targets (mean = .86) than the intervention group (mean = 5.00; P = .001). Ratings of depth perception, bimanual dexterity, efficiency, tissue handling, autonomy, and overall competence were higher for the intervention group. Effect sizes ranged from medium to large (.394-.981), indicating an impact of the proficiency-based training protocol.


CONCLUSIONS
Delineation of proficiency targets with reporting of progress improves interns' practice results, and appears to have a positive effect on their early operating room (OR) performance of laparoscopic cholecystectomy.
Gauger
Paul G
PG
Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA. pgauger@med.umich.edu
Hauge
Linnea S
LS
Andreatta
Pamela B
PB
Hamstra
Stanley J
SJ
Hillard
Miranda L
ML
Arble
Eamonn P
EP
Kasten
Steven J
SJ
Mullan
Patricia B
PB
Cederna
Paul S
PS
Minter
Rebecca M
RM
D000704:Analysis of Variance; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D003162:Competency-Based Education; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D013647:Task Performance and Analysis; D014481:United States; D014584:User-Computer Interface; D014741:Video Recording