title: Single versus multimodality training basic laparoscopic skills.
abstract: BACKGROUND
  Even though literature provides compelling evidence of the value of simulators for training of basic laparoscopic skills, the best way to incorporate them into a surgical curriculum is unclear. This study compares the training outcome of single modality training with multimodality training of basic laparoscopic skills.
  
  
  METHODS
  Thirty-six medical students without laparoscopic experience performed six training sessions of 45 min each, one per day, in which four different basic tasks were trained. Participants in the single-modality group (S) (n = 18) practiced solely on a virtual reality (VR) simulator. Participants in the multimodality group (M) (n = 18) practiced on the same VR simulator (2x), a box trainer (2x), and an augmented reality simulator (2x). All participants performed a pre-test and post-test on the VR simulator (the four basic tasks + one additional basic task). Halfway through the training protocol, both groups performed a salpingectomy on the VR simulator as interim test.
  
  
  RESULTS
  Both groups improved their performance significantly (Wilcoxon signed-rank, P < 0.05). The performances of group S and group M in the additional basic task and the salpingectomy did not differ significantly (Mann-Whitney U test, P > 0.05). Group S performed the four basic tasks in the post-test on the VR faster than group M (P ≤ 0.05), which can be explained by the fact that they were much more familiar with these tasks.
  
  
  CONCLUSIONS
  Training of basic laparoscopic tasks on single or multiple modalities does not result in different training outcome. Both training methods seem appropriate for the attainment of basic laparoscopic skills in future curricula.
authors.affiliation: Department of Urology, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. wmbrinkman@gmail.com
authors.forename: Willem M
authors.initials: WM
authors.lastname: Brinkman
authors.forename: Sanne Y
authors.initials: SY
authors.lastname: Havermans
authors.forename: Sonja N
authors.initials: SN
authors.lastname: Buzink
authors.forename: Sanne M B I
authors.initials: SM
authors.lastname: Botden
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Jakimowicz
authors.forename: Benedictus C
authors.initials: BC
authors.lastname: Schoot
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D011597:Psychomotor Performance; D013997:Time Factors; D014584:User-Computer Interface