Surgical educationLearning curves and impact of previous operative experience on performance on a virtual reality simulator to test laparoscopic surgical skills
Section snippets
Setting
The study was carried out in two gastroenterological surgical units of teaching hospitals. None of the participants in the study had had previous contact with the MIST-VR.
Procedures
Forty-one surgeons (30 male) were tested on the MIST-VR 10 consecutive times within a 1-month period. The participants were divided into three groups according to their experience in laparoscopic surgery: masters (group 1, 8 subjects who had performed more than 100 cholecystectomies); intermediates (group 2, 8 subjects who had
Results
The learning curve patterns for the three groups of surgeons can be seen on Fig. 1. The curves regarding time reached plateau after the second repetition for group 1, the fifth repetition for group 2, and the seventh repetition for group 3 (Friedman’s tests, P <0.05). Experienced surgeons did not improve their error- or economy of movement scores (Friedman’s tests, P >0.2) indicating the absence of a learning curve for these parameters. Group 2 error scores reached plateau after the first
Comments
The present study provides data on the rate of acquisition of laparoscopic psychomotor skills in a virtual environment as well as demonstrates the construct validity of the MIST system. Clinical experience has shown that there is a significant learning curve for each surgeon and for each new laparoscopic procedure, such as fundoplication, cholecystectomy, and appendectomy [4]. This learning phase includes 10 to 30 patients and results in longer operating room time, higher complication rates,
Acknowledgements
This study was supported by Sygekassernes Helsefond, Copenhagen, Denmark.
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