title: Effective home laparoscopic simulation training: a preliminary evaluation of an improved training paradigm.
abstract: BACKGROUND
  Laparoscopic simulation training has proven to be effective in developing skills but requires expensive equipment, is a challenge to integrate into a work-hour restricted surgical residency, and may use nonoptimal practice schedules. The purpose of this study was to evaluate the efficacy of laparoscopic skills training at home using inexpensive trainer boxes.
  
  
  METHODS
  Residents (n = 20, postgraduate years 1-5) enrolled in an institutional review board-approved laparoscopic skills training protocol. An instructional video was reviewed, and baseline testing was performed using the fundamentals of laparoscopic surgery (FLS) peg transfer and suturing tasks. Participants were randomized to home training with inexpensive, self-contained trainer boxes or to simulation center training using standard video trainers. Discretionary, goal-directed training of at least 1 hour per week was encouraged. A posttest and retention test were performed. Intragroup and intergroup comparisons as well as the relationship between the suture score and the total training sessions, the time in training, and attempts were studied.
  
  
  RESULTS
  Intragroup comparisons showed significant improvement from baseline to the posttest and the retention test. No differences were shown between the groups. The home-trained group practiced more, and the number of sessions correlated with suture retention score (r(2) = .54, P < .039).
  
  
  CONCLUSIONS
  Home training results in laparoscopic skill acquisition and retention. Training is performed in a more distributed manner and trends toward improved skill retention.
authors.affiliation: Department of Surgery, Tulane University Health Sciences Center, SL-22, 1430 Tulane Avenue, New Orleans, LA 70112-2699, USA. korndorffer@tulane.edu
authors.forename: James R
authors.initials: JR
authors.lastname: Korndorffer
authors.forename: Charles F
authors.initials: CF
authors.lastname: Bellows
authors.forename: Ara
authors.initials: A
authors.lastname: Tekian
authors.forename: Ilene B
authors.initials: IB
authors.lastname: Harris
authors.forename: Steven M
authors.initials: SM
authors.lastname: Downing
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence; D003194:Computer-Assisted Instruction / Q000295:instrumentation*; D004502:Education, Medical, Continuing / Q000379:methods*; D017144:Focus Groups; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D016014:Linear Models; D018709:Statistics, Nonparametric; D013536:Suture Techniques; D013997:Time Factors; D014584:User-Computer Interface; D014741:Video Recording