title: Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized trial.
abstract: OBJECTIVE
  To investigate the impact of instructor feedback versus no instructor feedback when training a complex operational task on a laparoscopic virtual reality simulator.
  
  
  BACKGROUND
  : Simulators are now widely accepted as a training tool, but there is insufficient knowledge about how much feedback is necessary, which is useful for sustainable implementation.
  
  
  METHODS
  A randomized trial complying with CONSORT Statement. All participants had to reach a predefined proficiency level for a complex operational task on a virtual reality simulator. The intervention group received standardized instructor feedback a maximum of 3 times. The control group did not receive instructor feedback. Participants were senior medical students without prior laparoscopic experience (n = 99). Outcome measures were time, repetitions, and performance score to reach a predefined proficiency level. Furthermore, influence of sex and perception of own surgical skills were examined.
  
  
  RESULTS
  Time (in minutes) and repetitions were reduced in the intervention group (162 vs 342 minutes; P < 0.005) and (29 vs 65 repetitions; P < 0.005). The control group achieved a higher performance score than the intervention group (57% vs 49%; P = 0.004). Men used less time (in minutes) than women (P = 0.037), but no sex difference was observed for repetitions (P = 0.20). Participants in the intervention group had higher self-perception regarding surgical skills after the trial (P = 0.011).
  
  
  CONCLUSIONS
  Instructor feedback increases the efficiency when training a complex operational task on a virtual reality simulator; time and repetitions used to achieve a predefined proficiency level were significantly reduced in the group that received instructor feedback compared with the control group.
  
  
  BACKGROUND
  NCT01497782.
authors.affiliation: Department of OBGYN, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark. jeanett78@gmail.com
authors.forename: Jeanett
authors.initials: J
authors.lastname: Strandbygaard
authors.forename: Flemming
authors.initials: F
authors.lastname: Bjerrum
authors.forename: Mathilde
authors.initials: M
authors.lastname: Maagaard
authors.forename: Per
authors.initials: P
authors.lastname: Winkel
authors.forename: Christian Rifbjerg
authors.initials: CR
authors.lastname: Larsen
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ringsted
authors.forename: Christian
authors.initials: C
authors.lastname: Gluud
authors.forename: Teodor
authors.initials: T
authors.lastname: Grantcharov
authors.forename: Bent
authors.initials: B
authors.lastname: Ottesen
authors.forename: Jette Led
authors.initials: JL
authors.lastname: Sorensen
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D003718:Denmark; D004504:Education, Medical, Undergraduate / Q000379:methods*; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D058994:Salpingectomy / Q000193:education* / Q000379:methods; D012647:Self-Assessment; D012737:Sex Factors; D013997:Time Factors; D014584:User-Computer Interface; D018910:Video Games / Q000523:psychology