Retention of laparoscopic procedural skills acquired on a virtual-reality surgical trainer

• Published in: Surgical endoscopy Vol. 25; no. 3; pp. 722 - 727
• Main Authors: Maagaard, Mathilde, Sorensen, Jette Led, Oestergaard, Jeanett, Dalsgaard, Torur, Grantcharov, Teodor P., Ottesen, Bent S., Larsen, Christian Rifbjerg
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.03.2011; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Biological and medical sciences; Clinical Competence; Computer Simulation; Computer-Assisted Instruction; Curricula; Curriculum; Digestive system. Abdomen; Education, Medical, Continuing; Education, Medical, Graduate; Educational Measurement; Endoscopy; Follow-Up Studies; Gastroenterology; Gynecologic Surgical Procedures - education; Gynecology; Hepatology; Humans; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; Laparoscopy - education; Laparoscopy - methods; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Obstetrics; Practice (Psychology); Proctology; Psychomotor Performance; Retention; Retention (Psychology); Skill development; Surgery; Time and Motion Studies; Time Factors; Training; User-Computer Interface; Validity; United States > US; Gynaecology; Curriculum; Retention; Virtual-reality simulator; Laparoscopic skills; Treatment; Surgery; Virtual reality; Laparoscopy; Endoscopy; Simulator; Augmented reality
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-010-1233-5

Background Virtual-reality (VR) simulator training has been shown to improve surgical performance in laparoscopic procedures in the operating room. We have, in a randomised controlled trial, demonstrated transferability to real operations. The validity of the LapSim virtual-reality simulator as an assessment tool has been demonstrated in several reports. However, an unanswered question regarding simulator training is the durability, or retention, of skills acquired during simulator training. The aim of the present study is to assess the retention of skills acquired using the LapSim VR simulator, 6 and 18 months after an initial training course. Methods and materials The investigation was designed as a 6- and 18-month follow-up on a cohort of participants who earlier participated in a skills training programme on the LapSim VR. The follow-up cohort consisted of trainees and senior consultants allocated to two groups: (1) novices (experience < 5 procedures, n  = 9) and (2) experts (experience > 200 procedures during the past 3 years, n  = 10). Each participant performed ten sessions. Assessment of skills was based on time, economy of movement and the error parameter “bleeding”. The novice group were re-tested after 6 and 18 months, whereas the expert group were only retested once, after 6 months. None of the novices performed laparoscopic surgery in the follow-up period. The experts continued their daily work with laparoscopic surgery. Results and conclusions Novices showed retention of skills after 6 months. After 18 months, novices’ laparoscopic skills had returned to the pre-training level. This indicates that laparoscopic skills seemed to deteriorate in the period between 6 and 18 months without training. Experts showed consistent performance over time. This information can be included when planning training curricula in minimal invasive surgery.