title: Development and evaluation of a simulator-based laparoscopic training program for surgical novices.
abstract: BACKGROUND
  The use of simulation to train novice surgeons in laparoscopic skills is becoming increasingly popular. To maximize benefit from simulation, training needs to be delivered and assessed in a structured manner. This study aimed to define performance goals, demonstrate construct validity of the training program, and evaluate whether novice surgeons could reach the preset performance goals.
  
  
  METHODS
  Nine expert laparoscopic surgeons established performance goals for three basic modules of an augmented-reality laparoscopic simulator. The three laparoscopic modules were used by 40 novice surgeons and 40 surgical trainees (postgraduate years [PGYs] 1-4). The performance outcomes were analyzed across the different groups (novice, PGYs 1 and 2, PGYs 3 and 4, expert) to determine construct validity. Then 26 recruited novices trained on the three modules with the aim of reaching the performance goals.
  
  
  RESULTS
  The results demonstrated a significant difference in performance between all levels of experience for time (p < 0.001), motion analysis (p < 0.001), and error score (p < 0.001), thus demonstrating construct validity. All 26 novice surgeons significantly improved in performance with repetition for the metrics of time (p < 0.001) and motion analysis (p < 0.001). For two of the modules, the proficiency goals were reached in fewer than 10 trials by 80% of the study participants.
  
  
  CONCLUSIONS
  Basic skills in laparoscopic surgery can be learned and improved using proficiency-based simulation training. It is possible for novice surgeons to achieve predefined performance goals in a reasonable time frame.
authors: National Surgical Training Centre, Royal College of Surgeons in Ireland, Dublin, Ireland. emmelinenugent@rcsi.ie
authors: Emmeline
authors: E
authors: Nugent
authors: Nicole
authors: N
authors: Shirilla
authors: Adnan
authors: A
authors: Hafeez
authors: Diarmuid S
authors: DS
authors: O'Riordain
authors: Oscar
authors: O
authors: Traynor
authors: Anthony M
authors: AM
authors: Harrison
authors: Paul
authors: P
authors: Neary
mesh_terms: D000293:Adolescent; D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000379:methods; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D007839:Functional Laterality; D013502:General Surgery / Q000193:education*; D006801:Humans; D007494:Ireland; D010535:Laparoscopy / Q000193:education* / Q000592:standards; D059032:Learning Curve; D008297:Male; D008348:Manikins; D055815:Young Adult