title: Comparison of fresh-frozen cadaver and high-fidelity virtual reality simulator as methods of laparoscopic training.
abstract: BACKGROUND
  The aim of this study was to compare fresh-frozen cadavers (FFC) with a high-fidelity virtual reality simulator (VRS) as training tools in minimal access surgery for complex and relatively simple procedures.
  
  
  METHODS
  A prospective comparative face validity study between FFC and VRS (LAP Mentor(™)) was performed. Surgeons were recruited to perform tasks on both FFC and VRS appropriately paired to their experience level. Group A (senior) performed a laparoscopic sigmoid colectomy, Group B (intermediate) performed a laparoscopic incisional hernia repair, and Group C (junior) performed basic laparoscopic tasks (BLT) (camera manipulation, hand-eye coordination, tissue dissection and hand-transferring skills). Each subject completed a 5-point Likert-type questionnaire rating the training modalities in nine domains. Data were analysed using nonparametric tests.
  
  
  RESULTS
  Forty-five surgeons were recruited to participate (15 per skill group). Median scores for subjects in Group A were significantly higher for evaluation of FFC in all nine domains compared to VRS (p < 0.01). Group B scored FFC significantly better (p < 0.05) in all domains except task replication (p = 0.06). Group C scored FFC significantly better (p < 0.01) in eight domains but not on performance feedback (p = 0.09). When compared across groups, juniors accepted VRS as a training model more than did intermediate and senior groups on most domains (p < 0.01) except team work.
  
  
  CONCLUSIONS
  Fresh-frozen cadaver is perceived as a significantly overall better model for laparoscopic training than the high-fidelity VRS by all training grades, irrespective of the complexity of the operative procedure performed. VRS is still useful when training junior trainees in BLT.
authors.affiliation: Department of General Surgery, Newcastle Surgical Training Centre, Freeman Hospital NHS Trust, High Heaton, Newcastle upon Tyne, NE12 8WQ, UK. dr_miteshsharma@yahoo.co.uk
authors.forename: Mitesh
authors.initials: M
authors.lastname: Sharma
authors.forename: Alan
authors.initials: A
authors.lastname: Horgan
mesh_terms: D002102:Cadaver; D002983:Clinical Competence; D003082:Colectomy / Q000379:methods; D004521:Educational Measurement; D004867:Equipment Design; D013502:General Surgery / Q000193:education*; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014584:User-Computer Interface