title: Laparoscopic assistance by operating room nurses: Results of a virtual-reality study.
abstract: BACKGROUND
  Laparoscopic assistance is often entrusted to a less experienced resident, medical student, or operating room nurse. Data regarding laparoscopic training for operating room nurses are not available.
  
  
  OBJECTIVE
  The aim of the study was to analyse the initial performance level and learning curves of operating room nurses in basic laparoscopic surgery compared with medical students and surgical residents to determine their ability to assist with this type of procedure.
  
  
  METHODS
  The study was designed to compare the initial virtual reality performance level and learning curves of user groups to analyse competence in laparoscopic assistance.
  
  
  METHODS
  The study subjects were operating room nurses, medical students, and first year residents.
  
  
  METHODS
  Participants performed three validated tasks (camera navigation, peg transfer, fine dissection) on a virtual reality laparoscopic simulator three times in 3 consecutive days. Laparoscopic experts were enrolled as a control group. Participants filled out questionnaires before and after the course.
  
  
  RESULTS
  Nurses and students were comparable in their initial performance (p>0.05). Residents performed better in camera navigation than students and nurses and reached the expert level for this task. Residents, students, and nurses had comparable bimanual skills throughout the study; while, experts performed significantly better in bimanual manoeuvres at all times (p<0.05).
  
  
  CONCLUSIONS
  The included user groups had comparable skills for bimanual tasks. Residents with limited experience reached the expert level in camera navigation. With training, nurses, students, and first year residents are equally capable of assisting in basic laparoscopic procedures.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medicine of the Johannes Gutenberg-University Mainz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Paschold
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medicine of the Johannes Gutenberg-University Mainz, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Huber
authors.affiliation: Department of Operating Room Management, University Medicine of the Johannes Gutenberg-University Mainz, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Maedge
authors.affiliation: Institute of Medical Biometry, Epidemiology and Informatics (IMBEI), Johannes Gutenberg-University, Mainz, Germany.
authors.forename: S R
authors.initials: SR
authors.lastname: Zeissig
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medicine of the Johannes Gutenberg-University Mainz, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Medicine of the Johannes Gutenberg-University Mainz, Germany. Electronic address: werner.kneist@unimedizin-mainz.de.
authors.forename: W
authors.initials: W
authors.lastname: Kneist
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education* / Q000295:instrumentation* / Q000451:nursing; D059032:Learning Curve; D009871:Operating Room Nursing / Q000592:standards*; D013337:Students, Medical; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis
keywords: Camera navigation; Laparoscopic assistance; Laparoscopic simulation; Surgical education