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The effect of simulation in improving students’ performance in laparoscopic surgery: a meta-analysis

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Abstract

Background

There is increasing interest in using simulators for laparoscopic surgery training, and simulators have rapidly become an integral part of surgical education.

Methods

We searched MEDLINE, EMBASE, Cochrane Library, and Google Scholar for randomized controlled studies that compared the use of different types of simulators. The inclusion criteria were peer-reviewed published randomized clinical trials that compared simulators versus standard apprenticeship surgical training of surgical trainees with little or no prior laparoscopic experience. Of the 551 relevant studies found, 17 trials fulfilled all inclusion criteria. The effect sizes (ES) with 95 % confidence intervals [CI] were calculated for multiple psychometric skill outcome measures.

Results

Data were combined by means of both fixed- and random-effects models. Meta-analytic combined effect size estimates showed that novice students who trained on simulators were superior in their performance and skill scores (d = 1.98, 95 % CI: 1.20–2.77; P < 0.01), were more careful in handling various body tissue (d = 1.08, 95 % CI: 0.36–1.80; P < 0.01), and had a higher accuracy score in conducting laparoscopic tasks (d = 1.38, 95 % CI: 0.30–2.47; P < 0.05).

Conclusion

Simulators have been shown to provide better laparoscopic surgery skills training for trainees than the traditional standard apprenticeship approach to skill development. Surgical residency programs are highly encouraged to adopt the use of simulators in teaching laparoscopic surgery skills to novice students.

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Disclosures

Drs. Azzam Al-Kadi, Tyrone Donnon, Elizabeth Oddone Paolucci, Philip Mitchell, Estifanos Debru, and Neal Church have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, College of Medicine, Qassim University, P.O. Box 6655, Buraidah, Qassim, 51452, Saudi Arabia

    Azzam S. Al-Kadi

  2. Department of Upper GI and Laparoscopic Surgery, Peter Lougheed Center, Calgary, AB, Canada

    Azzam S. Al-Kadi, Philip Mitchell, Estifanos Debru & Neal Church

  3. Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada

    Azzam S. Al-Kadi, Tyrone Donnon & Elizabeth Oddone Paolucci

Authors
  1. Azzam S. Al-Kadi
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  2. Tyrone Donnon
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  3. Elizabeth Oddone Paolucci
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  4. Philip Mitchell
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  5. Estifanos Debru
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  6. Neal Church
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Correspondence to Azzam S. Al-Kadi.

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Al-Kadi, A.S., Donnon, T., Oddone Paolucci, E. et al. The effect of simulation in improving students’ performance in laparoscopic surgery: a meta-analysis. Surg Endosc 26, 3215–3224 (2012). https://doi.org/10.1007/s00464-012-2327-z

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  • DOI: https://doi.org/10.1007/s00464-012-2327-z

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