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A Novel Virtual Reality-Based Curriculum Improves Laparoscopic Skills in Novices
Michael Martinez, Kurt E Roberts, Robert L Bell, James Dziura, Dan Eisenberg, Walter E Longo, Andrew J Duffy
Yale University School of Medicine, New Haven, CT

Objective: Training outside the operating room (OR) has become an essential component of surgical education. Computerized simulators are commonly used but factory settings and metrics are incompletely evaluated. We hypothesize our novel, virtual reality-based laparoscopic skill curriculum on LapSim will improve technical skills in novice trainees as measured by the Fundamentals of Laparoscopic Surgery (FLS) drills.
Design: Randomized control trial.
Setting: University Surgical Skills and Simulation Center
Participants: Thirty eight 1st and 2nd year medical students with no laparoscopic surgical or simulator experience volunteered and were randomly assigned to either a training (16 students) or nontraining control group (18). Four volunteers withdrew.
Interventions: All subjects were familiarized with laparoscopic skills and instruments. Baseline testing consisted of 3 repetitions of two FLS tasks (peg transfer and pattern cutting). The training group trained regularly with the goal of completing the curriculum. FLS tests were repeated at one month.
Main Outcome Measures: FLS performance scores were calculated for each task. Scores were compared both within and across groups for differences in improvement after one month.
Results: Baseline scores were similar between both groups for each task. One-month changes in test scores for each task were compared using analysis of covariance with adjustment for baseline test scores. Improved training group performance for peg transfer did not demonstrate signficance. In pattern cutting, the training group demonstrated significantly higher total scores at one month (p = .0333) and a significant mean improvement over baseline scores versus control (79 versus 33, p= 0.0418).
Conclusions: Participation in our laparoscopic curriculum improved novice skill development as determined by FLS scores. Successful completion of our curriculum should result in improved OR performance for trainees.


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