8033 Development of Laparoscopic Skills in Skills-Naïve Trainees Using Self-Directed Learning with Take-Home Laparoscopic Trainer Boxes

Abstract

<h3>Study Objective</h3> Our study aims to evaluate the utility of take-home laparoscopic trainer boxes with self-directed learning in the development of laparoscopic skills in medical students and surgically naïve gynecology interns. <h3>Design</h3> Prospective cohort study. <h3>Setting</h3> Tertiary care university hospital. <h3>Patients or Participants</h3> 74 medical students and beginning OB/Gyn interns (postgraduate year 1). <h3>Interventions</h3> Participants performed a laparoscopic peg transfer task with only task instructions and no additional training. Tasks were recorded and scored by adding completion time to penalties for dropped pegs. Participants subsequently took home a laparoscopic trainer box for 3 weeks to practice without guidance and returned to perform the peg transfer task for a final score. <h3>Measurements and Main Results</h3> Initial and final peg transfer scores were compared for improvement. Improvement was compared to practice as well as variables such as demographics, surgical interest, comfort with laparoscopy, and past experiences. Mean peg transfer task scores improved from 287 seconds to 193 seconds (p<0.001). Score improvement showed a positive correlation with number of home practice sessions with a linear regression R² of 0.134 (p=0.001). More practice, both in time and number of sessions, resulted in larger increases in comfort levels, and higher comfort levels correlated with better final task scores with a linear regression R² of 0.152 (p<0.001). Medical students interested in surgery had less practice sessions (p=0.496), however, interest in a surgical field had no impact on final scores or improvement. Playing a musical instrument and having two or more hobbies involving manual dexterity was associated with a better baseline score (p=0.032 and p=0.033 respectively), but no difference in the final scores or score improvement. No other past experiences impacted initial or final scores. <h3>Conclusion</h3> Our study demonstrates that the use of home laparoscopic box trainers can develop laparoscopic skills in surgical novices even without formal guidance or curriculum.