Retention of laparoscopic psychomotor skills after a structured training program depends on the quality of the training and on the complexity of the task.

Carlos Roger Molinas,Rudi Campo

doi:10.1007/s10397-016-0962-4

Carlos Roger Molinas, Rudi Campo

Open Access

https://doi.org/10.1007/s10397-016-0962-4

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Abstract

This follow-up RCT was conducted to evaluate laparoscopic psychomotor skills retention after finishing a structured training program. In a first study, 80 gynecologists were randomly allocated to four groups to follow different training programs for hand-eye coordination (task 1) with the dominant hand (task 1-a) and the non-dominant hand (task 1-b) and laparoscopic intra-corporeal knot tying (task 2) in the Laparoscopic Skills Testing and Training (LASTT) model. First, baseline skills were tested (T1). Then, participants trained task 1 (G1: 1-a and 1-b, G2: 1-a only, G3 and G4: none) and then task 2 (all groups but G4). After training all groups were tested again to evaluate skills acquisition (T2). For this study, 2 years after a resting period, 73 participants were recruited and tested again to evaluate skills retention (T3). All groups had comparable skills at T1 for all tasks. At T2, G1, G2, and G3 improved their skills, but the level of improvement was different (G1 = G2 > G3 > G4 for task 1; G1 = G2 = G3 > G4 for task 2). At T3, all groups retained their task 1 skills at the same level than at T2. For task 2, however, a skill decay was already noticed for G2 and G3, being G1 the only group that retained their skills at the post-training level. Training improves laparoscopic skills, which can be retained over time depending on the comprehensiveness of the training program and on the complexity of the task. For high complexity tasks, full training is advisable for both skills acquisition and retention.

Highlights

The ideal method for training in laparoscopic surgery is an issue of continuous debate and research
To facilitate the training and assessment of three specific basic laparoscopic psychomotor skills, the European Academy of Gynecological Surgery has developed an inanimate box model (i.e., the Laparoscopic Skills Testing and Training (LASTT) model) and demonstrated its feasibility, its face validity, and its construct validity [6, 7]
At Test 2 (T2), all groups that performed some kind of training improved their scores, being 44 (37–48) for G1 (P < 0.0001), 42 (37–51) for G2 (P < 0.0001), and 75 (62–95) for G3 (P < 0.0001), whereas G4 did not show any improvement and scored 201 (171–253) (NS)

Summary

Introduction

The ideal method for training in laparoscopic surgery is an issue of continuous debate and research. To facilitate the training and assessment of three specific basic laparoscopic psychomotor skills (i.e., camera navigation, hand-eye coordination, and bimanual coordination), the European Academy of Gynecological Surgery has developed an inanimate box model (i.e., the Laparoscopic Skills Testing and Training (LASTT) model) and demonstrated its feasibility, its face validity (the realism of the method), and its construct validity (the ability of the method to differentiate between novices and experts) [6, 7]. It is not sufficiently clear, the reasons why only some of them are retained at the post-training levels whereas some start deteriorating very soon [9,10,11,12,13]

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