title: Tailored instructor feedback leads to more effective virtual-reality laparoscopic training.
abstract: BACKGROUND
  Laparoscopic novices begin at different performance levels, and studies on tailored training concepts are warranted. The effect of verbal instructor feedback has been investigated with varying results, and its effectiveness in virtual-reality laparoscopic (VRL) simulations still is unclear. This study aimed to determine whether laparoscopic novices with lower initial performance statuses may profit from training with intensive instructor feedback.
  
  
  METHODS
  A prospective, single-blinded study was performed within a week-long curricular course. In this study, 20 medical students performed a complex bimanual maneuver on a VRL simulator. There was a division in performance levels, with a high-performer group (HPG) that received a better median score and a low-performer group (LPG). During the training phase, only the initial LPG received standardized instructor feedback in a one-to-one setting. The final assessment of skills for both groups involved performing the task without feedback at the end of the course.
  
  
  RESULTS
  The HPG and LPG showed significantly different initial performance levels according global and categorized (time, economics, error) scores (p < 0.005). This difference disappeared quickly throughout the instructor feedback phase. The final assessment demonstrated that both groups were at the same level of performance.
  
  
  CONCLUSIONS
  This is the first study to use a tailored training concept with instructor feedback limited to the LPG. The tailored training was effective and economic for the laparoscopic novices and their teachers.
authors.affiliation: Department of General, Visceral, and Transplant Surgery, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Paschold
authors.forename: T
authors.initials: T
authors.lastname: Huber
authors.forename: S R
authors.initials: SR
authors.lastname: Zeißig
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.forename: Werner
authors.initials: W
authors.lastname: Kneist
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D004502:Education, Medical, Continuing / Q000379:methods*; D005246:Feedback; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D008297:Male; D011446:Prospective Studies; D016037:Single-Blind Method; D013663:Teaching / Q000379:methods / Q000592:standards*; D014584:User-Computer Interface; D055815:Young Adult