A randomized crossover trial examining low- versus high-fidelity simulation in basic laparoscopic skills training
- 366 Downloads
Previous randomized studies have compared high- versus low-fidelity laparoscopic simulators; however, no proficiency criteria were defined and results have been mixed. The purpose of this research was to determine whether there were any differences in the learning outcomes of participants who had trained to proficiency on low- or high-fidelity laparoscopic surgical simulators.
We conducted a randomized, prospective crossover trial with participants recruited from New South Wales, Western Australia, and South Australia. Participants were randomized to high-fidelity (LapSim, Surgical Science) or low-fidelity (FLS, SAGES) laparoscopic simulators and trained to proficiency in a defined number of tasks. They then crossed over to the other fidelity simulator and were tested. The outcomes of interest were the crossover mean scores, the proportion of tasks passed, and percentage passes for the crossover simulator tasks.
Of the 228 participants recruited, 100 were randomized to LapSim and 128 to FLS. Mean crossover score increased from baseline for both simulators, but there was no significant difference between them (11.0 % vs. 11.9 %). FLS-trained participants passed a significantly higher proportion of crossover tasks compared with LapSim-trained participants (0.26 vs. 0.20, p = 0.016). A significantly higher percentage of FLS-trained participants passed intracorporeal knot tying than LapSim-trained participants (35 % vs. 8 %, p < 0.001).
Similar increases in participant score from baseline illustrate that training on either simulator type is beneficial. However, FLS-trained participants demonstrated a greater ability to translate their skills to successfully complete LapSim tasks. The ability of FLS-trained participants to transfer their skills to new settings suggests the benefit of this simulator type compared with the LapSim.
KeywordsFLS LapSim Proficiency-based training Simulation Surgical education Laparoscopy
- 1.Semm K (1983) Die endoskopische Appendektomie. Gynakolog Prax 7:131–140Google Scholar
- 2.Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst 4:CD006231Google Scholar
- 17.Kothari SN, Kaplan BJ, DeMAria EJ, Broderick TJ, Merrell RC (2002) Training in laparoscopic suturing skills using a new computer-based virtual reality simulator (MIST–VR) provides results comparable to those with an established pelvic trainer system. J Laparoendosc Adv Surg Tech 12:167–173CrossRefGoogle Scholar