title: Criterion-based laparoscopic training reduces total training time.
abstract: BACKGROUND
  The benefits of criterion-based laparoscopic training over time-oriented training are unclear. The purpose of this study is to compare these types of training based on training outcome and time efficiency.
  
  
  METHODS
  During four training sessions within 1 week (one session per day) 34 medical interns (no laparoscopic experience) practiced on two basic tasks on the Simbionix LAP Mentor virtual-reality (VR) simulator: 'clipping and grasping' and 'cutting'. Group C (criterion-based) (N = 17) trained to reach predefined criteria and stopped training in each session when these criteria were met, with a maximum training time of 1 h. Group T (time-based) (N = 17) trained for a fixed time of 1 h each session. Retention of skills was assessed 1 week after training. In addition, transferability of skills was established using the Haptica ProMIS augmented-reality simulator.
  
  
  RESULTS
  Both groups improved their performance significantly over the course of the training sessions (Wilcoxon signed ranks, P < 0.05). Both groups showed skill transferability and skill retention. When comparing the performance parameters of group C and group T, their performances in the first, the last and the retention training sessions did not differ significantly (Mann-Whitney U test, P > 0.05). The average number of repetitions needed to meet the criteria also did not differ between the groups. Overall, group C spent less time training on the simulator than did group T (74:48 and 120:10 min, respectively; P < 0.001). Group C performed significantly fewer repetitions of each task, overall and in session 2, 3 and 4.
  
  
  CONCLUSIONS
  Criterion-based training of basic laparoscopic skills can reduce the overall training time with no impact on training outcome, transferability or retention of skills. Criterion-based should be the training of choice in laparoscopic skills curricula.
authors: Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. wmbrinkman@gmail.com
authors: Willem M
authors: WM
authors: Brinkman
authors: Sonja N
authors: SN
authors: Buzink
authors: Leonidas
authors: L
authors: Alevizos
authors: Ignace H J T
authors: IH
authors: de Hingh
authors: Jack J
authors: JJ
authors: Jakimowicz
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D004210:Dissection / Q000193:education / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010535:Laparoscopy / Q000193:education* / Q000592:standards; D013664:Teaching Materials; D013997:Time Factors