title: Prospective, randomized assessment of the acquisition, maintenance, and loss of laparoscopic skills.
abstract: BACKGROUND
  Laparoscopic skills are difficult to learn. We, therefore, assessed the factors involved in skill acquisition, maintenance, and loss in 2 prospective, randomized studies.
  
  
  METHODS
  In study 1, 24 laparoscopic novices were randomly assigned to a control condition who performed the laparoscopic assessment task; Massed condition who trained on virtual reality (VR) simulation during 1 day or Interval condition who had the same amount of VR training distributed over 3 consecutive days. All groups also completed a novel laparoscopic box-trainer task on 5 consecutive days. In study 2, 16 laparoscopic novices were randomly assigned to a Practice or a No-practice condition. All subjects were required to train on a VR simulation curriculum for the same duration and skill attainment level. The week after completion of training, subjects in the Practice condition were allowed 1 complete practice trial on the simulator. Both groups completed the same tasks 2 weeks after completion of the training.
  
  
  RESULTS
  In study 1, the Interval trained group showed the fastest rate of learning and on completion of training significantly outperformed both the Massed and Control groups (P < 0.0001). In study 2, both groups showed significant skills improvement from training trial T1 to T3 (P < 0.0001). The subjects in the Practice group maintained or improved their skills at 1 week but those in the No practice group showed significant decline of skills at 2 weeks after training completion (P < 0.0001).
  
  
  CONCLUSIONS
  Laparoscopic skills are optimally acquired on an Interval training schedule. They significantly decline with 2 weeks of nonuse.
authors.affiliation: School of Medicine, University College Cork, Cork, Ireland. anthonyg.gallagher@btinternet.com
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Gallagher
authors.forename: Julie Anne
authors.initials: JA
authors.lastname: Jordan-Black
authors.forename: Gerald C
authors.initials: GC
authors.lastname: O'Sullivan
mesh_terms: D000293:Adolescent; D000328:Adult; D004501:Education, Medical / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D011446:Prospective Studies; D013663:Teaching / Q000379:methods*; D013997:Time Factors; D014584:User-Computer Interface; D055815:Young Adult