Abstract
BackgroundThree-dimensional (3D) visual displays have been suggested to aid laparoscopic skills training by providing the depth cues not present in traditional two-dimensional (2D) displays. However, few studies have robustly investigated the impact of viewing mode (2D vs. 3D) on learning outcomes.PurposeTo examine how viewing mode (2D vs. 3D) impacts the acquisition and transferability of basic laparoscopic skills by comparing performance between transfer and control groups on a complete proficiency-based training program.MethodA counterbalanced between-subjects design was employed. Each participant was randomly allocated to one of four groups, comprising two transfer groups (trained in one viewing mode and tested in the alternate mode: the 2D → 3D and 3D → 2D groups) and two control groups (trained and tested in one viewing mode: the 2D → 2D and 3D → 3D groups). Participants completed proficiency-based training in six laparoscopic training tasks. Testing included two further repetitions of all tasks under test conditions. Objective performance measures included the total number of repetitions to reach proficiency, and total performance scores (i.e. time + error penalties across all repetitions) in training and testing.ResultsThe groups trained in 3D demonstrated superior training performance (i.e. less time + errors) and took fewer repetitions to reach proficiency than the groups trained in 2D. The groups tested in 3D also demonstrated superior test performance compared to those tested in 2D. However, training mode did not yield significant test differences between the groups tested in 2D (i.e. 2D → 2D vs. 3D → 2D), or between the groups tested in 3D (i.e. 3D → 3D vs. 2D → 3D).ConclusionNovices demonstrate superior performance in laparoscopic skills training using a 3D viewing mode compared to 2D. However, this does not necessarily translate to superior performance in subsequent testing or enhanced learning overall. Rather, test performance appears to be dictated by the viewing mode used during testing, not that of prior training.
Highlights
Three-dimensional (3D) visual displays have been suggested to aid laparoscopic skills training by providing the depth cues not present in traditional two-dimensional (2D) displays
Baseline checks As expected, post hoc tests indicated that there was no significant difference in the number of repetitions between the two groups trained in 3D, or between the two groups trained in 2D (Table 2)
Baseline checks As expected, post hoc tests indicated that there was no significant difference in total performance scores between the two groups trained in 3D, or between the two groups trained in 2D (Table 2)
Summary
Three-dimensional (3D) visual displays have been suggested to aid laparoscopic skills training by providing the depth cues not present in traditional two-dimensional (2D) displays. Conclusion Novices demonstrate superior performance in laparoscopic skills training using a 3D viewing mode compared to 2D. This does not necessarily translate to superior performance in subsequent testing or enhanced learning overall. Research indicates that 80% of major laparoscopic complications occur early on in a surgeon’s career (often within the first 100 cases), and can lead to disastrous patient outcomes including permanent injury or fatality [2,3,4] It is important for contemporary training methods to accelerate the learning curve and provide trainees with a platform to further optimise laparoscopic skills within the training period [5]. Laparoscopic surgeons must be able to demonstrate surgical proficiency with any and all display types
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