Original reportThe effects of practice and instruction on speed and accuracy during resident acquisition of simulated laparoscopic skills☆
Introduction
In recent years, surgical programs have increased their use of laparoscopic simulators in efforts to incorporate laparoscopy into the surgical curriculum and to remove some elementary aspects of skills training from the operating room. Although simulators are readily available, relatively inexpensive, and easy to use, little is known as to the effects and relative importance of practice and instruction on both quantitative and qualitative measures of residents’ skill acquisition.
The study reported herein focuses on the use of a laparoscopic simulator to teach basic laparoscopic surgical (LS) skills to general surgery residents in PGY-1. Specifically, this study addresses the relative importance of practice and instruction with respect to improving both speed and accuracy in the performance of LS skills.
Section snippets
Subjects
Fourteen general surgery residents at the PGY-1 level of training were randomly assigned to 1 of 2 experimental conditions (n = 7 per group), either practice only (PO) or practice with instruction (PI). Each resident completed a form to document the number of times he or she had scrubbed, controlled the camera, and/or manipulated instruments during LS procedures, and the total number of procedures (open and laparoscopic) on which he or she had scrubbed. All data were collected during the months
Results
Table 1, Table 2provide descriptive statistics for each group and the results of statistical analyses comparing groups on prior operative experience and the time required to complete the first trial of each task. There were no statistically significant differences across groups with respect to these variables.
Figure 5, Figure 6 present the mean time required by subjects in each group to complete each trial of the cannulation and OP task, respectively. In both groups, a statistically significant
Discussion
The results of this study replicate those of previous studies, which suggest that practice, with or without instruction, results in a significant reduction in the time required by residents to acquire and perform simulator-based laparoscopic skills.1, 2, 3, 4, 5, 6 However, the results further suggest that, with the addition of dynamic instruction and feedback, improvements in performance speed may be accompanied by significant improvements in the quality of performance that are not likely to
References (10)
- et al.
Development of a model for training and evaluation of laparoscopic skills
Am J Surg
(1998) - et al.
Experience and visual perception in resident acquisition of laparoscopic surgical skills
Curr Surg
(2000) - et al.
Laparoscopic training in residency program
J Laparoendosc Surg
(1996) - et al.
A method of objectively evaluating improvements in laparoscopic skills
Surg Endosc
(1998) - et al.
Teaching laparoscopic surgical skills to general surgery residentsdevelopment of an individualized instructional approach
Focus Surg Educ
(1994)
Cited by (0)
- ☆
The work reported herein was supported by a research grant from the Association for Surgical Education.