Structured Training on Box Trainers for First Year Surgical Residents: Does It Improve Retention of Laparoscopic Skills? A Randomized Controlled Study

Supe, Avinash; Prabhu, Ramkrishna; Harris, Ilene B.; Downing, Steven M.; Tekian, Ara

doi:10.1016/j.jsurg.2012.05.002

Cited by 35 publications

(20 citation statements)

References 21 publications

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“…Most of the research contrasting simulation-based medical education (SBME) and traditional teaching methods to date has focused on residents, and was either concerned with complex surgical or intensive care procedures [43,44] or refers to cardiac life support training [18]. It is well known, that straight after training SBME with “deliberate practice” is superior to traditional clinical teaching in the acquisition of a broad variety of skills [38,45].…”

Section: Discussionmentioning

confidence: 99%

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

Herrmann–Werner¹,

Nikendei

Keifenheim³

et al. 2013

PLoS ONE

121

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BackgroundBenefits of skills lab training are widely accepted, but there is sparse research on its long-term effectiveness. We therefore conducted a prospective, randomised controlled-trial to investigate whether in a simulated setting students trained according to a "best practice" model (BPSL) perform two skills of different complexity (nasogastral tube insertion, NGT; intravenous cannulation, IVC) better than students trained with a traditional "see one, do one" teaching approach (TRAD), at follow-up of 3 or 6 months.Methodology and Principal Findings94 first-year medical students were randomly assigned to one of four groups: BPSL training or TRAD teaching with follow-up at 3 (3M) or 6 (6M) months. BPSL included structured feedback, practice on manikins, and Peyton’s "Four-Step-Approach", while TRAD was only based on the "see one - do one" principle. At follow-up, manikins were used to assess students’ performance by two independent blinded video-assessors using binary checklists and a single-item global assessment scale. BPSL students scored significantly higher immediately after training (NGT: BPSL3M 94.8%±0.2 and BPSL6M 95.4%±0.3 percentage of maximal score ± SEM; TRAD3M 86.1%±0.5 and TRAD6M 84.7%±0.4. IVC: BPSL3M 86.4%±0.5 and BPSL6M 88.0%±0.5; TRAD3M 73.2%±0.7 and TRAD6M 72.5%±0.7) and lost significantly less of their performance ability at each follow-up (NGT: BPSL3M 86.3%±0.3 and TRAD3M 70.3%±0.6; BPSL6M 89.0%±0.3 and TRAD6M 65.4%±0.6; IVC: BPSL3M 79.5%±0.5 and TRAD3M 56.5%±0.5; BPSL6M 73.2%±0.4 and TRAD6M 51.5%±0.8). In addition, BPSL students were more often rated clinically competent at all assessment times. The superiority at assessment after training was higher for the more complex skill (IVC), whereas NGT with its lower complexity profited more with regard to long-term retention.ConclusionsThis study shows that within a simulated setting BPSL is significantly more effective than TRAD for skills of different complexity assessed immediately after training and at follow-up. The advantages of BPSL training are seen especially in long-term retention.

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Section: Discussionmentioning

confidence: 99%

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

Herrmann–Werner¹,

Nikendei

Keifenheim³

et al. 2013

PLoS ONE

121

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“…A study by Supe and colleagues underscores the importance of a low-cost laparoscopic trainer. 18 They investigated skill retention of the traditional observe and assist laparoscopy training alone vs the addition of lowcost laparoscopic trainers as an adjunct. The residents were tested at day one and then 5 months after performing the global operative assessment of laparoscopic skills (GOALS) rating scale.…”

Section: Discussionmentioning

confidence: 99%

Multi-institutional Evaluation of Producing and Testing a Novel 3D-Printed Laparoscopic Trainer

Parkhomenko¹,

Yoon²,

Okhunov³

et al. 2019

Urology

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OBJECTIVE To create, distribute, and evaluate the efficacy of a portable, cost-effective 3D-printed laparoscopic trainer for surgical skills development. METHODS The UCI Trainer (UCiT) laparoscopic simulator was developed via computer-aided designs (CAD), which were used to 3D-print the UCiT. Once assembled, a tablet computer with a rearfacing camera was attached for video and optics. Four institutions were sent the UCiT CAD files with a 3D-printer and instructions for UCiT assembly. For a comparison of the UCiT to a standard trainer, peg transfer and intracorporeal knot tying skills were accessed. These tasks were scored, and participants were asked to rate their experience with the trainers. Lastly, a questionnaire was given to individuals who 3D-printed and assembled the UCiT. RESULTS We recruited 25 urologists; none had any 3D-printing experience. The cost of printing each trainer was $26.50 USD. Each institution used the Apple iPad for optics. Six of eight participants assembled the UCiT in < 45 minutes, and rated assembly as somewhat easy. On objective scoring, participants performed tasks equally well on the UCiT vs the conventional trainer. On subjective scoring, the conventional trainer provided a significantly better experience vs the UCiT; however, all reported that the UCiT was useful for surgical education. CONCLUSION The UCiT is a low cost, portable training tool that is easy to assemble and use. UCiT provided a platform whereby participants performed laparoscopic tasks equal to performing the same tasks on the more expensive, nonportable standard trainer. UROLOGY 124: 297−301, 2019.

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“…29Y31 In addition, one study showed that skills were retained 5 months after completion of simulation. 31 Whereas these studies were performed mainly in residency programs, where residents were learning the basics of laparoscopy, simulation initiatives could also be applied to training in advanced laparoscopic techniques, including radical surgery and retroperitoneal dissection. Programs may not have the resources to develop a simulation program involving animal and cadaver models; however, objective improvement in surgical skills was seen even with simple box trainers.…”

Section: Discussionmentioning

confidence: 99%

Make New Friends But Keep the Old: Minimally Invasive Surgery Training in Gynecologic Oncology Fellowship Programs

Ring

Ramírez²,

Conrad³

et al. 2015

Int J Gynecol Cancer

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Objectives To evaluate the role of minimally invasive surgery (MIS) in gynecologic oncology fellowship training and fellows’ predictions of their use of MIS in their future practice. Methods All fellows-in-training in American Board of Obstetrics and Gynecology-approved training programs were surveyed in 2012 through an online or mailed-paper survey. Data were analyzed and compared to results of a similar 2007 survey. Results Of 172 fellows, 69 (40%) responded. Ninety-nine percent of respondents (n=68) indicated that MIS was either very important or important in gynecologic oncology, a proportion essentially unchanged from 2007 (100%). Compared to 2007, greater proportions of fellows considered laparoscopic radical hysterectomy and node dissection for cervical cancer (87% vs 54%, p<0.0001) and trachelectomy and staging for cervical cancer (83% vs 32%, p<0.0001) appropriate for MIS. Of respondents, 92% believed that maximum or some emphasis should be placed on robotic-assisted surgery(RAS) and 89% on traditional laparoscopy during fellowship training. Ten percent rated their fellowship training in laparoendoscopic single-site surgery as very poor; 44% said that the question was not applicable. Most respondents (60%) in 2012 performed at least 11 procedures per month, whereas most respondents (45%) in 2007 performed 6 to 10 procedures per month (p=0.005). All respondents at institutions where robotic surgery was used were allowed to operate at the robotic console, and 63% of respondents reported that in RAS cases when a fellow sat at the robot, the fellow performed more than 50% of the case at the console. Conclusions These findings indicate that MIS in gynecologic oncology is here to stay. Fellowship programs should develop a systematic approach to training in MIS and in individual MIS platforms as they become more prevalent. Fellowship programs should also develop and apply an objective assessment of minimum proficiency in MIS to ensure that programs are adequately preparing trainees.

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Structured Training on Box Trainers for First Year Surgical Residents: Does It Improve Retention of Laparoscopic Skills? A Randomized Controlled Study

Cited by 35 publications

References 21 publications

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

“Best Practice” Skills Lab Training vs. a “see one, do one” Approach in Undergraduate Medical Education: An RCT on Students’ Long-Term Ability to Perform Procedural Clinical Skills

Multi-institutional Evaluation of Producing and Testing a Novel 3D-Printed Laparoscopic Trainer

Make New Friends But Keep the Old: Minimally Invasive Surgery Training in Gynecologic Oncology Fellowship Programs

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