title: Three-dimensional (3D) simulation versus two-dimensional (2D) enhances surgical skills acquisition in standardised laparoscopic tasks: a before and after study.
abstract: BACKGROUND
  The aim of this study is to determine if simulated 3D vision improves the speed and accuracy of laparoscopic phantom tasks in laparoscopically naïve subjects.
  
  
  METHODS
  Thirty laparoscopically naïve subjects were divided into matched groups according to age, sex, hand dominance and initial scores on a standardised visio-spatial test. Laprotrain(©) laparoscopic simulators were used, one attached to the standard 2D monitor and the other to a simulated 3D monitor and 3D glasses were worn by the subjects in this group. Five standardised laparoscopic tasks were developed and the subjects underwent testing on four separate occasions with more than 24 h between sessions. The subjects were timed for each task and errors were recorded by two independent observers. In the second part of the study, subjects switched to the opposite group and task times and errors were again recorded. Statistical differences between groups were calculated using student t-test and Fisher's exact test.
  
  
  RESULTS
  There were fifteen subjects in each group with no significant difference in demographic or psychometric variables. The mean time to complete the tasks was faster in the 3D group compared with the 2D group. There was a lower rate of errors noted in the 3D group compared with the 2D group but this only reached statistical significance in two of the five laparoscopic tasks. In the crossover study, subjects who had trained on simulated 3D had better task times and fewer errors compared to those who had trained on 2D simulators.
  
  
  CONCLUSIONS
  Training on a simulated 3D model (compared to standard 2D) allows trainees to reach proficiency sooner.
authors.affiliation: Department of Surgery, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Ashraf
authors.affiliation: Department of Surgery, St Luke's Hospital, Kilkenny, Ireland. Electronic address: daniellecol@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Collins
authors.affiliation: Department of Surgery, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Whelan
authors.affiliation: Department of Obstetrics & Gynaecology, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: O'Sullivan
authors.affiliation: Department of Surgery, St Luke's Hospital, Kilkenny, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Balfe
mesh_terms: D000328:Adult; D002983:Clinical Competence; D065187:Controlled Before-After Studies; D018592:Cross-Over Studies; D003867:Depth Perception; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D008297:Male; D011597:Psychomotor Performance; D013647:Task Performance and Analysis; D055815:Young Adult
keywords: Laparoscopy; Medical education; Simulation training