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Development and evaluation of a simulator-based laparoscopic training program for surgical novices

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Abstract

Background

The use of simulation to train novice surgeons in laparoscopic skills is becoming increasingly popular. To maximize benefit from simulation, training needs to be delivered and assessed in a structured manner. This study aimed to define performance goals, demonstrate construct validity of the training program, and evaluate whether novice surgeons could reach the preset performance goals.

Methods

Nine expert laparoscopic surgeons established performance goals for three basic modules of an augmented-reality laparoscopic simulator. The three laparoscopic modules were used by 40 novice surgeons and 40 surgical trainees (postgraduate years [PGYs] 1–4). The performance outcomes were analyzed across the different groups (novice, PGYs 1 and 2, PGYs 3 and 4, expert) to determine construct validity. Then 26 recruited novices trained on the three modules with the aim of reaching the performance goals.

Results

The results demonstrated a significant difference in performance between all levels of experience for time (p < 0.001), motion analysis (p < 0.001), and error score (p < 0.001), thus demonstrating construct validity. All 26 novice surgeons significantly improved in performance with repetition for the metrics of time (p < 0.001) and motion analysis (p < 0.001). For two of the modules, the proficiency goals were reached in fewer than 10 trials by 80 % of the study participants.

Conclusion

Basic skills in laparoscopic surgery can be learned and improved using proficiency-based simulation training. It is possible for novice surgeons to achieve predefined performance goals in a reasonable time frame.

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Disclosures

Emmeline Nugent, Nicole Shirilla, Adnan Hafeez, Diarmuid S. O’Riordain, Oscar Traynor, Anthony M. Harrison, and Paul Neary have no conflicts of interest or financial ties to disclosure.

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Authors and Affiliations

  1. National Surgical Training Centre, Royal College of Surgeons in Ireland, 123, St. Stephen’s Green, Dublin 2, Ireland

    Emmeline Nugent, Oscar Traynor & Paul Neary

  2. School of Medicine, UPMC, Pittsburgh, PA, USA

    Nicole Shirilla & Anthony M. Harrison

  3. UPMC Beacon Hospital, Sandyford, Dublin, Ireland

    Adnan Hafeez, Diarmuid S. O’Riordain & Paul Neary

Authors
  1. Emmeline Nugent
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  2. Nicole Shirilla
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  3. Adnan Hafeez
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  4. Diarmuid S. O’Riordain
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  5. Oscar Traynor
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  6. Anthony M. Harrison
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  7. Paul Neary
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Correspondence to Emmeline Nugent.

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Nugent, E., Shirilla, N., Hafeez, A. et al. Development and evaluation of a simulator-based laparoscopic training program for surgical novices. Surg Endosc 27, 214–221 (2013). https://doi.org/10.1007/s00464-012-2423-0

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  • DOI: https://doi.org/10.1007/s00464-012-2423-0

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