Mastery versus the standard proficiency target for basic laparoscopic skill training: effect on skill transfer and...

Area of Science:

• Surgical Education
• Medical Simulation
• Laparoscopic Skills Training

Background:

• Limited guidance exists for implementing simulation in surgical skills curricula.
• This study addresses the effectiveness of part-task training in laparoscopic surgery.

Purpose of the Study:

• To investigate if practicing Fundamentals of Laparoscopic Surgery (FLS) peg transfer (PT) improves learning of intracorporeal suturing (ICS).
• To compare the effects of PT training to mastery versus training to a passing level on PT retention and ICS learning.

Main Methods:

• 98 surgically naive subjects were randomized into control, standard PT training, or overtraining groups.
• All participants trained in ICS; learning curves were analyzed using nonlinear regression.
• Skill retention was assessed after 1 month; groups were compared using ANOVA and transfer effectiveness ratio (TER).

Main Results:

• The ICS learning plateau increased with higher levels of PT training.
• Increased PT training showed a trend toward higher initial ICS scores and faster learning rates.
• No differences in PT retention scores were found; overtraining PT took longer than time saved in ICS training.

Conclusions:

• Part-task training with PT alone showed slight improvements in the ICS learning curve for novice surgeons.
• Overtraining PT did not enhance skill retention.
• Peg transfer training alone is not an efficient strategy for learning intracorporeal suturing.