Transferability of laparoscopic skills using the virtual reality simulator
Skill transfer represents an important issue in surgical education, and is not well understood. The aim of this randomized study is to assess the transferability of surgical skills between two laparoscopic abdominal procedures using the virtual reality simulator in surgical novices.
From September 2016 to July 2017, 44 surgical novices were randomized into two groups and underwent a proficiency-based basic training consisting of five selected simulated laparoscopic tasks. In group 1, participants performed an appendectomy training on the virtual reality simulator until they reached a defined proficiency. They moved on to the tutorial procedural tasks of laparoscopic cholecystectomy. Participants in group 2 started with the tutorial procedural tasks of laparoscopic cholecystectomy directly. Finishing the training, participants of both groups were required to perform a complete cholecystectomy on the simulator. Time, safety and economy parameters were analysed.
Significant differences in the demographic characteristics and previous computer games experience between the two groups were not noted. Both groups took similar time to complete the proficiency-based basic training. Participants in group 1 needed significantly less movements (388.6 ± 98.6 vs. 446.4 ± 81.6; P < 0.05) as well as shorter path length (810.2 ± 159.5 vs. 945.5 ± 187.8 cm; P < 0.05) to complete the cholecystectomy compared to group 2. Time and safety parameters did not differ significantly between both groups.
The data demonstrate a positive transfer of motor skills between laparoscopic appendectomy and cholecystectomy on the virtual reality simulator; however, the transfer of cognitive skills is limited. Separate training curricula seem to be necessary for each procedure for trainees to practise task-specific cognitive skills effectively. Mentoring could help trainees to get a deeper understanding of the procedures, thereby increasing the chance for the transfer of acquired skills.
KeywordsSkill transfer Laparoscopic training Virtual reality simulator Mentoring
Compliance with ethical standards
Cui Yang, Uljana Kalinitschenko, Juergen Weitz, Christoph Reissfelder, Jens R. Helmert and Soeren Torge Mees have no conflict of interest or financial ties to disclose.
- 1.Singley MK, Anderson JR (1989) The transfer of cognitive skill. Harvard University Press, CambridgeGoogle Scholar
- 5.Thorndike EL (1914) Educational psychology: briefer course. Columbia University Press, New YorkGoogle Scholar
- 6.Baker J, Côté J (2006) Shifting training requirements during athlete development: deliberate practice, deliberate play and other sport involvement in the acquisition of sport expertise. Essent Process Attaining Peak Perform 1:92–109Google Scholar
- 10.Magill RA (2011) Motor learning and control: concepts and applications. McGraw-Hill, New YorkGoogle Scholar
- 13.Peters JH, Fried GM, Swanstrom LL, Soper NJ, Sillin LF, Schirmer B, Hoffman K, SAGES FLS Committee (2004) Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 135:21–27. https://doi.org/10.1016/S0039 CrossRefPubMedGoogle Scholar
- 15.Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236:458–463. https://doi.org/10.1097/01.SLA.0000028969.51489.B4 (discussion 463–464)CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Kowalewski K-F, Hendrie JD, Schmidt MW, Garrow CR, Bruckner T, Proctor T, Paul S, Adigüzel D, Bodenstedt S, Erben A, Kenngott H, Erben Y, Speidel S, Müller-Stich BP, Nickel F (2017) Development and validation of a sensor- and expert model-based training system for laparoscopic surgery: the iSurgeon. Surg Endosc 31:2155–2165. https://doi.org/10.1007/s00464-016-5213-2 CrossRefPubMedGoogle Scholar
- 22.Sabbagh R, Chatterjee S, Chawla A, Hoogenes J, Kapoor A, Matsumoto ED (2012) Transfer of laparoscopic radical prostatectomy skills from bench model to animal model: a prospective, single-blind, randomized, controlled study. J Urol 187:1861–1866. https://doi.org/10.1016/j.juro.2011.12.050 CrossRefPubMedGoogle Scholar
- 23.Kolozsvari NO, Kaneva P, Brace C, Chartrand G, Vaillancourt M, Cao J, Banaszek D, Demyttenaere S, Vassiliou MC, Fried GM, Feldman LS (2011) Mastery versus the standard proficiency target for basic laparoscopic skill training: effect on skill transfer and retention. Surg Endosc 25:2063–2070. https://doi.org/10.1007/s00464-011-1743-9 CrossRefPubMedGoogle Scholar