Effectiveness of box trainers in laparoscopic training

Area of Science:

• Medical Education
• Surgical Training
• Minimally Invasive Surgery

Background:

• Virtual reality trainers offer advanced laparoscopic skill development but are costly and technologically demanding.
• Box trainers represent a more accessible alternative for laparoscopic surgical training in resource-limited settings.
• Objective assessment of surgical skills is crucial for competency-based medical education.

Purpose of the Study:

• To evaluate the effectiveness of a box-training course in improving laparoscopic skills among surgical trainees.
• To determine if a short-term, intensive training program can enhance objective performance metrics.
• To assess the utility of global rating scales and checklists for evaluating laparoscopic proficiency.

Main Methods:

• A six-day laparoscopic skills training workshop was conducted in 2006.
• Twenty-five surgeons with no prior laparoscopic experience participated.
• Participants' skills were quantitatively assessed using a global rating scale and task-specific checklist before and after the training, with improvements calculated as a percentage of the initial score.

Main Results:

• A significant mean percentage improvement of 44.5% in overall scores was observed using the global rating scale (P<0.0001).
• Task 1 showed a mean percentage improvement of 49.4%, and Task 2 showed a mean percentage improvement of 39.6%.
• The Wilcoxon matched-paired signed-ranks test indicated extremely significant improvements in performance.

Conclusions:

• A short-term, intensive box-training course effectively enhances laparoscopic skills in surgical trainees.
• Box trainers facilitate a transition from didactic to objective, competency-based surgical education.
• Global rating scales and checklists offer an inexpensive yet effective method for objectively assessing laparoscopic surgical skills.