The impact of aptitude on the learning curve for laparoscopic suturing.
BACKGROUND
Within surgery, several specialties demand advanced technical skills, specifically in the minimally invasive environment.


METHODS
Two groups of 10 medical students were recruited on the basis of their aptitude (visual-spatial ability, depth perception, and psychomotor ability). All subjects were tested consecutively using the ProMIS III simulator until they reached proficiency performing laparoscopic suturing. Simulator metrics, critical error scores, observed structured assessment of technical skills scores, and Fundamentals of Laparoscopic Surgery scores were recorded.


RESULTS
Group A (high aptitude) achieved proficiency after a mean of 7 attempts (range, 4-10). In group B (low aptitude), 30% achieved proficiency after a mean of 14 attempts (range, 10-16). In group B, 40% demonstrated improvement but did not attain proficiency, and 30% failed to progress.


CONCLUSIONS
Distinct learning curves for laparoscopic suturing can be mapped on the basis of fundamental ability. High aptitude is directly related to earlier completion of the learning curve. A proportion of subjects with low aptitude are unable to reach proficiency despite repeated attempts.
National Surgical Training Centre, Royal College of Surgeons in Ireland, 121 St Stephens Green, Dublin 2, Ireland. Electronic address: bucklece@tcd.ie.
Christina E
CE
Buckley
National Surgical Training Centre, Royal College of Surgeons in Ireland, 121 St Stephens Green, Dublin 2, Ireland.
Dara O
DO
Kavanagh
National Surgical Training Centre, Royal College of Surgeons in Ireland, 121 St Stephens Green, Dublin 2, Ireland.
Emmeline
E
Nugent
National Surgical Training Centre, Royal College of Surgeons in Ireland, 121 St Stephens Green, Dublin 2, Ireland.
Donncha
D
Ryan
National Surgical Training Centre, Royal College of Surgeons in Ireland, 121 St Stephens Green, Dublin 2, Ireland.
Oscar J
OJ
Traynor
National Surgical Training Centre, Royal College of Surgeons in Ireland, 121 St Stephens Green, Dublin 2, Ireland.
Paul C
PC
Neary
D000293:Adolescent; D000328:Adult; D001076:Aptitude; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D008297:Male; D011597:Psychomotor Performance; D013337:Students, Medical / Q000523:psychology*; D013536:Suture Techniques / Q000193:education*; D055815:Young Adult
Aptitude; Laparoscopic suturing; Learning curve; Proficiency-based training; Simulation