Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons

BACKGROUND: This study compares a laparoscopic skill training protocol without proficiency targets to the same protocol with explicit targets and notification of progress. METHODS: Fourteen surgery interns were randomized into 2 groups. The intervention group received task-specific proficiency criteria to guide practice. The control group did not. After training, participants were evaluated by blinded faculty during laparoscopic cholecystectomy. RESULTS: The control group met significantly fewer of the 7 LapSim (Surgical Science Sweden AB, Goteborg) targets (mean = 1.14) than the intervention group (mean = 7.00; P = .001) and significantly fewer of the 5 video trainer targets (mean = .86) than the intervention group (mean = 5.00; P = .001). Ratings of depth perception, bimanual dexterity, efficiency, tissue handling, autonomy, and overall competence were higher for the intervention group. Effect sizes ranged from medium to large (.394-.981), indicating an impact of the proficiency-based training protocol. CONCLUSIONS: Delineation of proficiency targets with reporting of progress improves interns' practice results, and appears to have a positive effect on their early operating room (OR) performance of laparoscopic cholecystectomy. (C) 2010 Elsevier Inc. All rights reserved.