Abstract
BackgroundLaparoscopic training has become an important part of surgical education. Laparoscopic Roux-en-Y gastric bypass (RYGB) is the most common bariatric procedure performed. Surgeons must be well trained prior to operating on a patient. Multimodality training is vital for bariatric surgery. E-learning with videos is a standard approach for training. The present study investigates whether scoring the operation videos with performance checklists improves learning effects and transfer to a simulated operation.Methods/designThis is a monocentric, two-arm, randomized controlled trial. The trainees are medical students from the University of Heidelberg in their clinical years with no prior laparoscopic experience. After a laparoscopic basic virtual reality (VR) training, 80 students are randomized into one of two arms in a 1:1 ratio to the checklist group (group A) and control group without a checklist (group B). After all students are given an introduction of the training center, VR trainer and laparoscopic instruments, they start with E-learning while watching explanations and videos of RYGB. Only group A will perform ratings with a modified Bariatric Objective Structured Assessment of Technical Skill (BOSATS) scale checklist for all videos watched. Group B watches the same videos without rating. Both groups will then perform an RYGB in the VR trainer as a primary endpoint and small bowel suturing as an additional test in the box trainer for evaluation.DiscussionThis study aims to assess if E-learning and rating bariatric surgical videos with a modified BOSATS checklist will improve the learning curve for medical students in an RYGB VR performance. This study may help in future laparoscopic and bariatric training courses.Trial registrationGerman Clinical Trials Register, DRKS00010493. Registered on 20 May 2016.
Highlights
Introduction to laparoscopicRoux-en-Y gastric bypass by E-learning All trainees work with E-learning modalities for three hours as an introduction to RYGB after randomization
The primary objective of this study is to identify if students in group A, who undergo E-learning and rate surgical videos with a modified Bariatric Objective Structured Assessment of Technical Skill (BOSATS) checklist, will have a better learning curve while performing an RYGB with the virtual reality (VR) trainer than students in the control group, who use E-learning without rating the videos
Rating videos seems like an extra training for students; expectations are that trainees who perform the video ratings will have a better performance than those who just use E-learning and no rating
Summary
Roux-en-Y gastric bypass by E-learning All trainees work with E-learning modalities for three hours as an introduction to RYGB after randomization This is done in a standardized fashion by using the same room at the Department of Surgery at Heidelberg University Hospital with identical surrounding conditions in order to rule out any difference between trainees. The trainees are given an explanatory introduction by trained staff in a standardized way to begin the RYGB modalities on www.webop.de and www.websurg.com During this introduction, trainees are asked to study and understand the anatomy, illustrations, and videos of the procedural techniques. Learning technical and non-technical skills outside the OR is vital for MIS due to additional difficulties that prolong the learning curve These include pivot and fulcrum effects, lack of haptic feedback, and lack of a three-dimensional view [5]. VR has proven to be a safe and effective training modality for MIS, creating a virtual environment for laparoscopic basic skills and operations [7, 8]
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