Randomized trial to examine procedure-to-procedure transfer in laparoscopic simulator training.
BACKGROUND
Laparoscopic simulation has become a standard component of surgical training, but there is limited knowledge regarding skills transfer between procedural tasks. The objective was to investigate the specificity of procedural simulator training.


METHODS
This was randomized single-centre educational superiority trial. Surgical novices practised basic skills on a laparoscopic virtual reality simulator. On reaching proficiency, participants were randomized to proficiency-based training. The intervention group practised two procedures on the simulator (appendicectomy followed by salpingectomy), whereas the control group trained on only one procedure (salpingectomy). The main outcomes were number of repetitions and time to proficiency for the second procedure.


RESULTS
Ninety-six participants were randomized, of whom 74 per cent were women, with a median age of 26 years. The intervention group needed significantly fewer attempts than the control group to reach proficiency in the second procedure: median (i.q.r.) 22 (17-34) versus 32 (26-41) attempts, which corresponded to 24·1 per cent fewer attempts as assessed by multivariable analysis (P = 0·004). The intervention group required significantly less time than the control group to reach proficiency: median (i.q.r.) 88 (63-127) versus 131 (101-153) min respectively, corresponding to a difference of 31·1 min as assessed by multivariable analysis (P = 0·001).


CONCLUSIONS
Practising two procedures, compared with only one, reduced the number of attempts and time to reach proficiency in the second procedure. Skills transfer is seen between two tasks in laparoscopic simulator training; however, task specificity is still present when practising procedures.


BACKGROUND
NCT02069951 (http://www.clinicaltrials.gov).
Department of Obstetrics and Gynaecology, The Juliane Marie Centre for Children, Women and Reproduction, Copenhagen, Denmark.
F
F
Bjerrum
Department of Obstetrics and Gynaecology, The Juliane Marie Centre for Children, Women and Reproduction, Copenhagen, Denmark.
J L
JL
Sorensen
Centre for Clinical Education, Simulationscenter Rigshospitalet, Capital Region, Copenhagen, Denmark.
L
L
Konge
Section of Biostatistics, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
S
S
Rosthøj
Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
J
J
Lindschou
Department of Obstetrics and Gynaecology, The Juliane Marie Centre for Children, Women and Reproduction, Copenhagen, Denmark.
B
B
Ottesen
Department of Obstetrics and Gynaecology, The Juliane Marie Centre for Children, Women and Reproduction, Copenhagen, Denmark.
J
J
Strandbygaard
D000328:Adult; D001062:Appendectomy / Q000193:education* / Q000379:methods; D002983:Clinical Competence; D003198:Computer Simulation; D003718:Denmark; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D058994:Salpingectomy / Q000193:education* / Q000379:methods; D000066908:Simulation Training; D014584:User-Computer Interface