title: Learning basic laparoscopic skills: a randomized controlled study comparing box trainer, virtual reality simulator, and mental training.
abstract: OBJECTIVE
  The objectives of this study were (1) to compare different methods of learning basic laparoscopic skills using box trainer (BT), virtual reality simulator (VRS) and mental training (MT); and (2) to determine the most effective method of learning laparoscopic skills.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  King's College, London.
  
  
  METHODS
  41 medical students were included in the study. After randomization, they were divided into 5 groups. Group 1 was the control group without training; group 2 was box trained; group 3 was also box trained with an additional practice session; group 4 was VRS trained; and group 5 was solely mentally trained. The task was to cut out a circle marked on a stretchable material. All groups were assessed after 1 week on both BT and VRS. Four main parameters were assessed, namely time, precision, accuracy, and performance.
  
  
  RESULTS
  Time: On BT assessment, the box-trained group with additional practice group 3 was the fastest, and the mental-trained group 5 was the slowest. On VRS assessment, the time difference between group 3 and the control group 1 was statistically significant. Precision: On BT assessment, the box-trained groups 2 and 3 scored high, and mental trained were low on precision. On VRS assessment, the VRS-trained group ranked at the top, and the MT group was at the bottom on precision. Accuracy: On BT assessment, the box-trained group 3 was best and the mental-trained group was last. On VRS assessment, the VRS-trained group 4 scored high closely followed by box-trained groups 2 and 3. Performance: On BT assessment, the box-trained group 3 ranked above all the other groups, and the mental-trained group ranked last. On VRS assessment, the VRS group 4 scored best, followed closely by box-trained groups 2 and 3.
  
  
  CONCLUSIONS
  The skills learned on box training were reproducible on both VRS and BT. However, not all the skills learned on VRS were transferable to BT. Furthermore, VRS was found to be a reliable and the most convenient method of assessment. MT alone cannot replace conventional training.
authors.affiliation: King's College Hospital, Denmark Hill, London, United Kingdom. mubashirmulla@nhs.net
authors.forename: Mubashir
authors.initials: M
authors.lastname: Mulla
authors.forename: Davendra
authors.initials: D
authors.lastname: Sharma
authors.forename: Masood
authors.initials: M
authors.lastname: Moghul
authors.forename: Obeda
authors.initials: O
authors.lastname: Kailani
authors.forename: Judith
authors.initials: J
authors.lastname: Dockery
authors.forename: Salma
authors.initials: S
authors.lastname: Ayis
authors.forename: Philippe
authors.initials: P
authors.lastname: Grange
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D008606:Mental Processes; D008953:Models, Anatomic; D011597:Psychomotor Performance / Q000502:physiology; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013337:Students, Medical / Q000706:statistics & numerical data; D013647:Task Performance and Analysis; D013997:Time Factors; D006113:United Kingdom; D014584:User-Computer Interface; D055815:Young Adult