title: A randomized trial evaluating a cognitive simulator for laparoscopic appendectomy.
abstract: BACKGROUND
  The Integrated Cognitive Simulator (ICS) is a software application that integrates text, anatomy, video and simulation for training clinical procedures. The aim of this randomized controlled trial was to determine the usability of the ICS laparoscopic appendectomy module, and to determine its effectiveness in training the cognitive skills required for the procedure.
  
  
  METHODS
  Junior surgical trainees were randomized into control and intervention groups. The latter had access to the ICS. Participants had three assessments: a pre-study questionnaire to determine demographics, 20 multiple choice questions to assess procedural knowledge (training effectiveness) after 2 weeks, and a questionnaire to assess usability after 4 months.
  
  
  RESULTS
  Fifty-eight trainees were randomized. The overall response rate was 57%. The median scores for interface, functionality, usefulness and likelihood of utilization (usability) were 5/7 or higher. In the multiple choice questions (training effectiveness), first-year trainees in the intervention group scored higher than the control group (14.9 versus 12.1, P= 0.04), but second-year trainees did not. Use of the ICS did not alter the participants' perceived need for intra-operative guidance.
  
  
  CONCLUSIONS
  The ICS is considered highly usable by trainees. The ICS is effective for training cognitive skills for laparoscopic appendectomy among first-year surgical trainees. Training cognitive skills alone does not increase confidence in the ability to perform motor tasks.
authors.affiliation: Department of Surgery, University of Auckland, New Zealand Advanced Clinical Skills Centre, University of Auckland, New Zealand Information Technology Services, University of Auckland, New Zealand.
authors.forename: Benjamin P T
authors.initials: BP
authors.lastname: Loveday
authors.forename: George V
authors.initials: GV
authors.lastname: Oosthuizen
authors.forename: B Scott
authors.initials: BS
authors.lastname: Diener
authors.forename: John A
authors.initials: JA
authors.lastname: Windsor
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000379:methods*; D003071:Cognition; D003198:Computer Simulation; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012984:Software; D025321:Surgery, Computer-Assisted / Q000379:methods*; D011795:Surveys and Questionnaires