Laparoscopic simulation training: does timing impact the quality of skills acquisition?
BACKGROUND
Current surgical training involves integration of educational interventions together with service requirements during regular working hours. Studies have shown that voluntary training has a low acceptance among surgical trainees and obligatory simulation training during the regular working week leads to better skill acquisition and retention. We examined the difference in training effectiveness depending on the time of day.


METHODS
Surgical novices underwent a curriculum consisting of nine basic laparoscopic tasks. The subjects were permitted to choose a training session between during regular working hours (8:00-16:00) or after hours (16:00-20:00). Each subject underwent baseline and post-training evaluation after completion of two 4-h sessions. Task completion was measured in time (s), with penalties for inaccurate performance. Statistical analysis included matched-pairs analysis (sex, age, and previous operative experience) with χ(2) und Mann-Whitney U test for between groups and Wilcoxon signed-rank test for testing within one group.


RESULTS
There were no differences in demographic characteristics between the groups. Comparison of the individual baseline and post-training performance scores showed a significant (P < 0.05) improvement for all subjects in all exercises. No significant differences between groups were observed.


CONCLUSIONS
All subjects improved in skill significantly throughout the week regardless of the timing of the training intervention. Simulation training can be offered outside of regular working hours with acceptable effectiveness.
Department of General and Visceral Surgery, University Hospital Muenster, Muenster, Germany. bonrathe@smh.ca
Esther M
EM
Bonrath
Mathias
M
Fritz
Soeren T
ST
Mees
Barbara K
BK
Weber
Teodor P
TP
Grantcharov
Norbert
N
Senninger
Emile
E
Rijcken
D000328:Adult; D002940:Circadian Rhythm; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000592:standards; D008297:Male; D009864:Ontario; D013997:Time Factors; D055815:Young Adult