Abstract
BackgroundThe aim of this study was to examine the influence of training under direct vision prior to training with indirect vision on the learning curve of the laparoscopic suture task.MethodsNovices were randomized in two groups. Group 1 performed three suturing tasks in a transparent laparoscopic box trainer under direct vision followed by three suturing tasks in a standard non-transparent laparoscopic box trainer equipped with a 0° laparoscope. Group 2 performed six suturing tasks in a standard laparoscopic box trainer. Performance time, motion analysis parameters (economy of movements) and interaction force parameters (tissue handling) were measured. Participants completed a questionnaire assessing: self-perceived dexterity before and after the training, their experienced frustration and the difficulty of the training.ResultsA total of 34 participants were included, one was excluded because of incomplete training. Group 1 used significantly less time to complete the total of six tasks (27 %). At the end of the training, there were no differences in motion or force parameters between the two groups. Group 2 rated their self-perceived dexterity after the training significantly lower than before the training and also reported significantly higher levels of frustration compared to group 1. Both groups rated the difficulty of the training similar.ConclusionNovices benefit from starting their training of difficult basic laparoscopic skills, e.g., suturing, in a transparent box trainer without camera. It takes less time to complete the tasks, and they get less frustrated by the training with the same results on their economy of movements and tissue handling skills.
Highlights
Background The aim of this study was to examine the influence of training under direct vision prior to training with indirect vision on the learning curve of the laparoscopic suture task
The current study shows that novices that start training in an open box trainer perform better for the trials done in that box, but when they switch to the closed box their performance curves essentially overlap with those of students
Novices that train in the open box spent 27 % less time training, while they achieve similar proficiency after six trials and subjectively report less frustration
Summary
Novices (i.e., first- and second-year medical students in the preclinical phase of their studies) were recruited by means of advertisement on bulletin boards in the Medical Faculty of Leiden and in the Medical Library of the Leiden University Medical Center (LUMC). The intervention group first performed the training task three times under direct vision in the interventional setup (trial one till three). Proficiency gain curves for time, path length, volume, maximum force, mean absolute nonzero force and force volume are plotted as means with 95 % CI Differences in these parameters between the intervention and control group were determined with the independent samples t test (P \ 0.05). Group 1 uses 27 % less time than group 2 to perform the full training
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