title: The LapSim virtual reality simulator: promising but not yet proven.
abstract: BACKGROUND
  The acquisition of technical skills using surgical simulators is an area of active research and rapidly evolving technology. The LapSim is a virtual reality simulator that currently allows practice of basic laparoscopic skills and some procedures. To date, no reviews have been published with reference to a single virtual reality simulator.
  
  
  METHODS
  A PubMed search was performed using the keyword "LapSim," with further papers identified from the citations of original search articles.
  
  
  RESULTS
  Use of the LapSim to develop surgical skills has yielded overall results, although inconsistencies exist. Data regarding the transferability of learned skills to the operative environment are encouraging as is the validation work, particularly the use of a combination of measured parameters to produce an overall comparative performance score.
  
  
  CONCLUSIONS
  Although the LapSim currently does not have any proven significant advantages over video trainers in terms of basic skills instruction and although the results of validation studies are variable, the potential for such technology to have a huge impact on surgical training is apparent. Work to determine standardized learning curves and proficiency criteria for different levels of trainees is incomplete. Moreover, defining which performance parameters measured by the LapSim accurately determine laparoscopic skill is complex. Further technological advances will undoubtedly improve the efficacy of the LapSim, and the results of large multicenter trials are anticipated.
authors.affiliation: Department of Surgery, The Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, Adelaide, SA, 5011, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Fairhurst
authors.forename: Andrew
authors.initials: A
authors.lastname: Strickland
authors.forename: Guy
authors.initials: G
authors.lastname: Maddern
mesh_terms: D001315:Australia; D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods; D005260:Female; D005544:Forecasting; D013502:General Surgery / Q000193:education; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D008297:Male; D014584:User-Computer Interface