title: Introduction of a comprehensive training curriculum in laparoscopic surgery for medical students: a randomized trial.
abstract: BACKGROUND
  First- and second-year medical students have limited exposure to basic surgical skills. An introductory, comprehensive, simulation-based curriculum in basic laparoscopic skills may improve medical students' knowledge and technical and nontechnical skills and may raise their interest in a career in surgery. The purpose of this study was to (1) design a comprehensive, simulation-based training curriculum (STC) aimed to introduce junior medical students to basic laparoscopic skills and (2) compare structured and supervised learning and practice to a self-directed approach.
  
  
  METHODS
  Twenty-four, pre-clerkship medical students were allocated randomly to either a supervised (STC) or a self-directed learning and practice (SDL) group. Participants in the STC group received structured training in cognitive, and basic technical and nontechnical domains of laparoscopic surgery, whereas the SDL group was invited to engage in SDL in the same domains.
  
  
  RESULTS
  At post-training assessment, basic knowledge about laparoscopic surgery, and attitudes toward nontechnical skills were equivalent between STC and SDL groups. The STC group outperformed (mean ± standard deviation) the SDL group on a peg transfer task (58 ± 13 vs 81 ± 19 seconds; P = .005). Participants in the STC group showed significant within-group improvements in knowledge, technical skill, and in 4 of 5 domains of nontechnical skills, whereas participants in the SDL group showed significant within-group improvement in technical skill and in 1 of 5 domains of nontechnical skills.
  
  
  CONCLUSIONS
  Participation in the STC resulted in significant gains in knowledge, technical skill, and attitudes toward nontechnical skills. Exposure of junior medical students to this curriculum before their clinical rotations is expected to enhance learning, maintain motivation, and increase interest in surgery as a future career.
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nada
authors.initials: N
authors.lastname: Gawad
authors.affiliation: University of Toronto, Toronto, Ontario, Canada. Electronic address: boris.zevin@mail.utoronto.ca.
authors.forename: Boris
authors.initials: B
authors.lastname: Zevin
authors.affiliation: St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Bonrath
authors.affiliation: St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Nicolas J
authors.initials: NJ
authors.lastname: Dedy
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Marisa
authors.initials: M
authors.lastname: Louridas
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Teodor P
authors.initials: TP
authors.lastname: Grantcharov
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D009864:Ontario; D012985:Software Design; D013337:Students, Medical / Q000523:psychology; D055815:Young Adult