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Is the aptitude of manual skills enough for assessing the training effect of students using a laparoscopy simulator?
1Department of Visceral, Thoracic and Vascular Surgery, Philipps-University of Marburg, Marburg, Germany. hassan@med.uni-marburg.de
Background:
The aim of this study was to determine if students are suitable candidates to assess the learning effect through a virtual reality laparoscopy simulator (LapSim).
Materials And Methods:
14 medical students in their final year without any previous experience with a virtual reality simulator were recruited as subjects. In order to establish a "base line" all subjects were instructed into the "clip application" task - a basis module of the laparoscopy simulator - at the beginning of the study. They were then randomized into two groups. Group A (n=7) had parameter adjusted to an easy level of performance, while group B (n=7) was adjusted to a difficult level. In both levels, errors simulated clinically relevant situations such as vessel rupture and subsequent bleeding. Each participant had to repeat the clip application task ten times consecutively.
Results:
The mean time for completion ten repetitions was 15 min pro participant in group A and 20 min in group B. From the first to the fifth repetition group A improved significantly the task completion time from 238.9 s to 103.3 s (p<0.007) consecutively and also improved the error score from 312 to 177 (p<0.07). At the tenth repetition they increased the task completion time from 103.3 s to 152.2 s (p<0.09) and increased their error score from 177 to 202 (p=0.25).From the first to the fifth repetition group B also improved the task completion time from 131.6 s to 104.5 s (p<0.31) consecutively and improved the error score from 235 to 208 (p<0.32) but at the tenth repetition they increased the task completion time from 104.5 s to 142.4 s (p<0.45) and clearly increased their error score from 208 to 244 (p<0.38).
Conclusion:
These results suggest that medical students, who lack clinical background, may be not suitable candidates for assessing the efficiency of a training model using a laparoscopy simulator. If medical students are appointed for such studies, they should receive didactic sessions in the context of a clinical curriculum prior to manual training.
