The Impact of Homemade Laparoscopic Box Trainers on Medical Student Surgical Skills: A Randomized Control Pilot Study

Abstract

<h3>Study Objective</h3> While instructional videos are commonly used in surgical education, there is a paucity of data on home laparoscopic box trainers. This pilot study evaluated impacts of augmenting instructional videos with these devices. <h3>Design</h3> This was a randomized controlled pilot study evaluating laparoscopic surgical performance on the LapSim virtual surgical simulator before and after a two-week curriculum of instructional videos alone (n=8, 47.1%) versus videos plus a home laparoscopic box trainer (n=9, 52.9%). The LapSim recorded mistake number, time, and instrument path length to complete each task. Participants completed surveys about their perceptions of surgery before and after the course. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> Preclinical medical students were recruited. Those with extensive surgical experience or did not complete the course were excluded. <h3>Interventions</h3> Two-week curriculum of instructional videos alone versus videos plus a home laparoscopic box trainer. <h3>Measurements and Main Results</h3> For the box trainer group vs. the videos alone group: mean change in mistakes was -10.0 (standard deviation [SD]:17.1) versus +0.5 (SD:21.59) (p=0.28); mean change in time was -433.24 (SD:304.67) seconds versus -366.16 (SD:240.10) seconds (p=0.62); mean change in instrument path length was -4.27 (SD:4.38) meters versus -3.19 (SD:4.86) meters (p=0.64). The box trainer group ranked "I feel as though surgery comes naturally" 1.58 points higher (95% confidence interval [CI]: 0.85, 2.32; p<0.01) and "I am worried about being skilled at surgery" 1.26 points lower (95% CI: 2.29, -0.24; p=0.02) upon completing the study. The videos alone group reported no significant changes in survey responses. <h3>Conclusion</h3> Home laparoscopic box trainers can generate confidence and reduce anxiety regarding surgical fields. This study provides a framework for future larger scale works.