Goal-directed laparoscopic training leads to better laparoscopic skill acquisition

Abstract

Laparoscopic skills training outside the operating room is becoming the standard for educating surgical residents. Because of the restrictions on the work week, it is imperative for this training to be efficient. We hypothesized that goal-directed laparoscopic training (GDLT) would result in better skill acquisition than laparoscopic training without goals (LT). Second-year general surgery residents participated in this study. Metrics were scores that incorporated time and errors. One group of residents (LT) went through a 10- week laparoscopic training course without goals; one group of residents (GDLT) was given goals to achieve during their course. Each group practiced for the same amount of time. The tasks were peg exercise, run the rope, pattern cutting, clip/cut vessel, extracorporeal knot tying, intracorporeal knot tying, and suturing device. Statistical analysis was performed via 2-tailed Mann-Whitney tests. There were 8 residents in the LT group and 7 residents in the GDLT. The GDLT group had statistically significant higher scores on 7 of the 8 tasks compared the LT group (P < .02 to P < .0001). The GDLT group performed better in the final task, suturing device, than the LT group, but this did not reach statistical significance (451 vs 414; P = .14). GDLT should be used by surgeons instead of LT. Future studies need to examine whether GDLT translates into a better operative technique and outcomes.