title: Laparoscopy training in surgical education: the utility of incorporating a structured preclinical laparoscopy course into the traditional apprenticeship method.
abstract: OBJECTIVE
  To investigate whether preclinical laparoscopy training offers a benefit over standard apprenticeship training and apprenticeship training in combination with simulation training.
  
  
  METHODS
  This randomized controlled trial consisted of 3 groups of first-year surgical registrars receiving a different teaching method in laparoscopic surgery.
  
  
  METHODS
  The KU LEUVEN Faculty of Medicine is the largest medical faculty in Belgium.
  
  
  METHODS
  Thirty final-year medical students starting a general surgical career in the next academic year.
  
  
  METHODS
  Thirty final-year medical students were randomized into 3 groups, which differed in the way they were exposed to laparoscopic simulation training but were comparable in regard to ambidexterity, sex, age, and laparoscopic psychomotoric skills. The control group received only clinical training during surgical residentship, whereas the interval group received clinical training in combination with simulation training. The registrars were allowed to do deliberate practice. The Centre for Surgical Technologies Preclinical Training Programme (CST PTP) group received a preclinical simulation course during the final year as medical students, but was not exposed to any extra simulation training during surgical residentship. At the beginning of surgical residentship and 6 months later, all subjects performed a standardized suturing task and a laparoscopic cholecystectomy in a POP Trainer. All procedures were recorded together with time and motion tracking parameters. All videos were scored by a blinded observer using global rating scales.
  
  
  RESULTS
  At baseline the 3 groups were comparable. At 6 months, for suturing, the CST PTP group was better than both the other groups with respect to time, checklist, and amount of movements. The interval group was better than the control group on only the time and checklist score. For the cholecystectomy evaluation, there was a statistical difference between the CST PTP study group and both other groups on all evaluation scales in favor of the CST PTP group.
  
  
  CONCLUSIONS
  Structured, preclinical proficiency-based training is better than clinical training combined with laboratory training or clinical training alone.
authors.affiliation: Centre for Surgical Technologies, K.U.LEUVEN, Leuven, Belgium; Department of Urology, University Hospitals K.U.LEUVEN, Leuven, Belgium; Department of Urology, University Hospital Antwerp, Antwerp, Belgium. Electronic address: gunterdewin@me.com.
authors.forename: Gunter
authors.initials: G
authors.lastname: De Win
authors.forename: Siska
authors.initials: S
authors.lastname: Van Bruwaene
authors.forename: Rajesh
authors.initials: R
authors.lastname: Aggarwal
authors.forename: Nicola
authors.initials: N
authors.lastname: Crea
authors.forename: Zhewen
authors.initials: Z
authors.lastname: Zhang
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.forename: Marc
authors.initials: M
authors.lastname: Miserez
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000193:education; D057189:Checklist; D002763:Cholecystectomy / Q000193:education; D005260:Female; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D008297:Male; D013996:Time and Motion Studies; D013520:Urologic Surgical Procedures / Q000193:education*; D014572:Urology / Q000193:education*; D055815:Young Adult
keywords: Practice-Based Learning and Improvement; apprenticeship; deliberate practice; laparoscopy training; preclinical training; proficiency based; simulation