title: Use of box simulators for improving intraoperative laparoscopic skills - an essential tool for the surgeon in training.
abstract: OBJECTIVE
  To compare the improvement of intraoperative laparoscopic skills by measuring GOALS score between residents who have undergone simulator training with those who have not received any simulator training.
  
  
  METHODS
  A randomized controlled trial.
  
  
  METHODS
  Department of Surgery, Services Hospital, Lahore, from August 2013 to February 2014.
  
  
  METHODS
  Thirty residents belonging to year 1, 2 and 3 were included in the study. They were randomly divided into 2 groups. Both groups had a baseline evaluation with GOALS score while performing dissection of gallbladder from liver bed during laparoscopic cholecystectomy. Group-A underwent formal training on simulators whereas group-B did not receive any formal training on simulators. After 6 months, a repeat evaluation was done again by measuring GOALS score while performing gallbladder dissection.
  
  
  RESULTS
  Baseline GOALS scores of both the groups were similar. Group-A baseline score was 7.66 ± 0.93 and group-B score was 7.46 ± 1.04 (p = 0.585). However repeat scores for group-A showed a significant improvement (an increase of 7.16 ± 1.48 to 14.76 ± 1.67, p < 0.001) from baseline scores. Residents in group-B improved their scores by 2.30 ± 0.99 to 9.76 ± 0.79 (p < 0.001). When inter group comparison was done the second score of group-A was significantly higher than that of group-B (14.76 ± 1.67 vs. 9.76 ± 0.79, p < 0.001). Inter-rater reliability was moderately significant (Kappa 0.540).
authors.affiliation: Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Awais Amjad
authors.initials: AA
authors.lastname: Malik
authors.affiliation: Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Ayyaz
authors.affiliation: Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Muhammad Farooq
authors.initials: MF
authors.lastname: Afzal
authors.affiliation: Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Abrar Ashraf
authors.initials: AA
authors.lastname: Ali
authors.affiliation: Department of Plastic Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Romaisa
authors.initials: R
authors.lastname: Shamim
authors.affiliation: Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Ruqayya
authors.initials: R
authors.lastname: Khan
authors.affiliation: Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Huma Sabir
authors.initials: HS
authors.lastname: Khan
authors.affiliation: Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Awais
authors.initials: A
authors.lastname: Naeem
authors.affiliation: Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
authors.forename: Samiullah
authors.initials: S
authors.lastname: Bhatti
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008953:Models, Anatomic; D013043:Specialties, Surgical / Q000193:education*; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods*