title: Virtual reality training versus blended learning of laparoscopic cholecystectomy: a randomized controlled trial with laparoscopic novices.
abstract: This study compared virtual reality (VR) training with low cost-blended learning (BL) in a structured training program.Training of laparoscopic skills outside the operating room is mandatory to reduce operative times and risks.Laparoscopy-naïve medical students were randomized in 2 groups stratified for sex. The BL group (n = 42) used E-learning for laparoscopic cholecystectomy (LC) and practiced basic skills with box trainers. The VR group (n = 42) trained basic skills and LC on the LAP Mentor II (Simbionix, Cleveland, OH). Each group trained 3 × 4 hours followed by a knowledge test concerning LC. Blinded raters assessed the operative performance of cadaveric porcine LC using the Objective Structured Assessment of Technical Skills (OSATS). The LC was discontinued when it was not completed within 80 min. Students evaluated their training modality with questionnaires.The VR group completed the LC significantly faster and more often within 80 min than BL (45% v 21%, P = .02). The BL group scored higher than the VR group in the knowledge test (13.3 ± 1.3 vs 11.0 ± 1.7, P < 0.001). Both groups showed equal operative performance of LC in the OSATS score (49.4 ± 10.5 vs 49.7 ± 12.0, P = 0.90). Students generally liked training and felt well prepared for assisting in laparoscopic surgery. The efficiency of the training was judged higher by the VR group than by the BL group.VR and BL can both be applied for training the basics of LC. Multimodality training programs should be developed that combine the advantages of both approaches.
authors.affiliation: From the Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany (FN, JAB, HMR, JC, HGK, GRL, MK, LF, BPM-S); and Department of Psychology, University of Copenhagen, Copenhagen, Denmark (MG).
authors.forename: Felix
authors.initials: F
authors.lastname: Nickel
authors.forename: Julia A
authors.initials: JA
authors.lastname: Brzoska
authors.forename: Matthias
authors.initials: M
authors.lastname: Gondan
authors.forename: Henriette M
authors.initials: HM
authors.lastname: Rangnick
authors.forename: Jackson
authors.initials: J
authors.lastname: Chu
authors.forename: Hannes G
authors.initials: HG
authors.lastname: Kenngott
authors.forename: Georg R
authors.initials: GR
authors.lastname: Linke
authors.forename: Martina
authors.initials: M
authors.lastname: Kadmon
authors.forename: Lars
authors.initials: L
authors.lastname: Fischer
authors.forename: Beat P
authors.initials: BP
authors.lastname: Müller-Stich
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000193:education* / Q000592:standards; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D013337:Students, Medical; D013997:Time Factors; D014584:User-Computer Interface; D055815:Young Adult