Assessment of medical student laparoscopic camera skills and the impact of formal camera training

Abstract

Background In laparoscopic surgery, the role of camera holder often falls to untrained medical students. Laparoscopic-naive students can easily acquire laparoscopic camera navigation (LCN) skills, yet it is unclear whether this translates into improved LCN performance in the operating room and whether students retain these skills over time. The purpose of this study was to evaluate whether preclinical laparoscopic camera simulator training would result in improved LCN skills, efficiency, and comfort level over the course of a 6-week surgery clerkship. Methods A randomized, controlled study was designed to compare students' preclerkship and postclerkship LCN skills on a previously validated box trainer model. The students (n = 70) were randomized via a computer-generated table of random numbers into study and control groups. The study group (n = 36) received a brief laparoscope training session before the clerkship, while the control group (n = 36) did not. All students also completed a preclerkship and postclerkship questionnaire detailing their experience and comfort level. Results Statistical analysis using Wilcoxon's signed-rank test demonstrated that all students improved in skill level (total score, 4 vs 7; P < .0001), efficiency (time, 76 vs 33 seconds; P < .0001), and comfort level (Likert scale score, 2 vs 4; P < .0001), with no statistically significant difference between the control and study groups. Conclusions This study demonstrates that novice medical students are able to gain laparoscopic camera skills from “hands-on” experience, with no added benefit or retention of skills learned in a preclinical camera simulator training session.