title: Laparoscopic and robotic skills are transferable in a simulation setting: a randomized controlled trial.
abstract: Although surgical simulation provides an effective supplement to traditional training, it is not known whether skills are transferable between minimally invasive surgical modalities. The purpose of this study was to assess the transferability of skills between minimally invasive surgical simulation platforms among simulation-naïve participants.
  
  
  
  Forty simulation-naïve medical students were enrolled in this randomized single-blinded controlled trial. Participants completed a baseline evaluation on laparoscopic (Fundamentals of Laparoscopic Surgery Program, Los Angeles, CA) and robotic (dV-Trainer, Mimic, Seattle, WA) simulation peg transfer tasks. Participants were then randomized to perform a practice session on either the robotic (N = 20) or laparoscopic (N = 20) simulator. Two blinded, expert minimally invasive surgeons evaluated participants before and after training using a modified previously validated subjective global rating scale. Objective measures including time to task completion and Mimic dV-Trainer motion metrics were also recorded.
  
  
  
  At baseline, there were no significant differences between the training groups as measured by objective and subjective measures for either simulation task. After training, participants randomized to the laparoscopic practice group completed the laparoscopic task faster (p < 0.003) and with higher global rating scale scores (p < 0.001) than the robotic group. Robotic-trained participants performed the robotic task faster (p < 0.001), with improved economy of motion (p < 0.001), and with higher global rating scale scores (p = 0.006) than the laparoscopic group. The robotic practice group also demonstrated significantly improved performance on the laparoscopic task (p = 0.02). Laparoscopic-trained participants also improved their robotic performance (p = 0.02), though the robotic group had a higher percent improvement on the robotic task (p = 0.037).
  
  
  
  Skills acquired through practice on either laparoscopic or robotic simulation platforms appear to be transferable between modalities. However, participants demonstrate superior skill in the modality in which they specifically train.
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA. lthomai1@jhmi.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Thomaier
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 301 Mason Lord Drive, Suite 3200, Baltimore, MD, 21224, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Orlando
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 301 Mason Lord Drive, Suite 3200, Baltimore, MD, 21224, USA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Abernethy
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 301 Mason Lord Drive, Suite 3200, Baltimore, MD, 21224, USA.
authors.forename: Chandhana
authors.initials: C
authors.lastname: Paka
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 301 Mason Lord Drive, Suite 3200, Baltimore, MD, 21224, USA.
authors.forename: Chi Chiung Grace
authors.initials: CCG
authors.lastname: Chen
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D008297:Male; D065287:Robotic Surgical Procedures / Q000193:education*; D000066908:Simulation Training; D055815:Young Adult
keywords: Laparoscopy; Robotic skills; Simulation; Surgical simulation; Surgical training