4.2 Article

Learning Basic Laparoscopic Skills: A Randomized Controlled Study Comparing Box Trainer, Virtual Reality Simulator, and Mental Training

Journal

JOURNAL OF SURGICAL EDUCATION
Volume 69, Issue 2, Pages 190-195

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jsurg.2011.07.011

Keywords

simulation; laparoscopy; virtual reality simulator; box trainer; mental training

Funding

  1. STeLI
  2. London Deanery
  3. ACCESS Unit, King's College Hospital, London, United Kingdom

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OBJECTIVES: The objectives of this study were (1) to compare different methods of learning basic laparoscopic skills using box trainer (BT), virtual reality simulator (VRS) and mental training (MT); and (2) to determine the most effective method of learning laparoscopic skills. DESIGN: Randomized controlled trial. SETTING: King's College, London. METHODS: 41 medical students were included in the study. After randomization, they were divided into 5 groups. Group 1 was the control group without training; group 2 was box trained; group 3 was also box trained with an additional practice session; group 4 was VRS trained; and group 5 was solely mentally trained. The task was to cut out a circle marked on a stretchable material. All groups were assessed after 1 week on both BT and VRS. Four main parameters were assessed, namely time, precision, accuracy, and performance. RESULTS: Time: On BT assessment, the box-trained group with additional practice group 3 was the fastest, and the mental-trained group 5 was the slowest. On VRS assessment, the time difference between group 3 and the control group 1 was statistically significant. Precision: On BT assessment, the box-trained groups 2 and 3 scored high, and mental trained were low on precision. On VRS assessment, the VRS-trained group ranked at the top, and the MT group was at the bottom on precision. Accuracy: On BT assessment, the box-trained group 3 was best and the mental-trained group was last. On VRS assessment, the VRS-trained group 4 scored high closely followed by box-trained groups 2 and 3. Performance: On BT assessment, the box-trained group 3 ranked above all the other groups, and the mental-trained group ranked last. On VRS assessment, the VRS group 4 scored best, followed closely by box-trained groups 2 and 3. CONCLUSIONS: The skills learned on box training were reproducible on both VRS and BT. However, not all the skills learned on VRS were transferable to BT. Furthermore, VRS was found to be a reliable and the most convenient method of assessment. MT alone cannot replace conventional training. (J Surg 69:190-195. (C) 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

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