Criterion-based laparoscopic training reduces total training time

Willem M Brinkman, Sonja N Buzink, Leonidas Alevizos, Ignace H J T de Hingh, Jack J Jakimowicz, Willem M Brinkman, Sonja N Buzink, Leonidas Alevizos, Ignace H J T de Hingh, Jack J Jakimowicz

Abstract

Introduction: The benefits of criterion-based laparoscopic training over time-oriented training are unclear. The purpose of this study is to compare these types of training based on training outcome and time efficiency.

Methods: During four training sessions within 1 week (one session per day) 34 medical interns (no laparoscopic experience) practiced on two basic tasks on the Simbionix LAP Mentor virtual-reality (VR) simulator: 'clipping and grasping' and 'cutting'. Group C (criterion-based) (N = 17) trained to reach predefined criteria and stopped training in each session when these criteria were met, with a maximum training time of 1 h. Group T (time-based) (N = 17) trained for a fixed time of 1 h each session. Retention of skills was assessed 1 week after training. In addition, transferability of skills was established using the Haptica ProMIS augmented-reality simulator.

Results: Both groups improved their performance significantly over the course of the training sessions (Wilcoxon signed ranks, P < 0.05). Both groups showed skill transferability and skill retention. When comparing the performance parameters of group C and group T, their performances in the first, the last and the retention training sessions did not differ significantly (Mann-Whitney U test, P > 0.05). The average number of repetitions needed to meet the criteria also did not differ between the groups. Overall, group C spent less time training on the simulator than did group T (74:48 and 120:10 min, respectively; P < 0.001). Group C performed significantly fewer repetitions of each task, overall and in session 2, 3 and 4.

Conclusions: Criterion-based training of basic laparoscopic skills can reduce the overall training time with no impact on training outcome, transferability or retention of skills. Criterion-based should be the training of choice in laparoscopic skills curricula.

Figures

Fig. 1
Fig. 1
The study protocol
Fig. 2
Fig. 2
Boxplot of LAP Mentor parameters: time for the A clipping and grasping task and B cutting task, and path length for the C clipping and grasping and D cutting task

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Source: PubMed

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