title: Effects of Repetition and Inactivity on Laparoscopic Skills Training.
abstract: OBJECTIVE
  To describe the impact of task repetition and time between practice sessions on time to complete a surgical task using a high-fidelity laparoscopic simulator.
  
  
  METHODS
  An Institutional Review Board-approved retrospective cohort study of 33 obstetrics/gynecology residents with unlimited access to a high-fidelity laparoscopic simulator over a period of 12 months. Canadian Task Force design classification II-2.
  
  
  METHODS
  Academic medical center and obstetrics/gynecology residency training program.
  
  
  METHODS
  Obstetrics/gynecology residents.
  
  
  METHODS
  Participation in a high-fidelity laparoscopic training exercise.
  
  
  METHODS
  Residents completed a standardized peg transfer exercise with data collected on the time to completion of the exercise, number of the attempt, and interval since the last day of practice. Data were analyzed using Spearman correlation coefficients and mixed-effects linear regression.
  
  
  RESULTS
  A total of 33 residents participated during the 12-month period, completing 484 peg transfer exercises (mean, 16.2 per resident). Each repetition was correlated with a mean decrease in time to completion of 2.28 seconds (p < .0001). This correlation was most dramatic in the first 9 completed exercises, in which each repetition correlated with a decrease in time to complete of 7.98 seconds (p ≤ .0001). The lapse in practice preceding the exercise correlated with a negligible change in time to completion of 0.003 second (SD, 0.06; p = .90).
  
  
  CONCLUSIONS
  The number of previous completed exercises was significantly correlated with decreased time to completion of this standardized exercise. Lapses in practice did not correlate with slower times to completion, suggesting that repetitive exposure to a simple surgical task has a greater impact on efficiency than lapse in practice.
authors.affiliation: Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI. Electronic address: econnor@wihri.org.
authors.forename: Elizabeth V
authors.initials: EV
authors.lastname: Connor
authors.affiliation: Department of Research, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Christina
authors.initials: C
authors.lastname: Raker
authors.affiliation: Department of Female Pelvic Medicine and Reconstructive Surgery, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Wohlrab
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000592:standards*; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D008297:Male; D008953:Models, Anatomic; D009774:Obstetrics / Q000193:education*; D010820:Physicians / Q000592:standards*; D012189:Retrospective Studies
keywords: Laparoscopy; Resident education; Simulation