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A randomized crossover trial examining low- versus high-fidelity simulation in basic laparoscopic skills training.

Swee Chin Tan¹, Nicholas Marlow, John Field

¹Department of Surgery, The Royal Adelaide Hospital, Adelaide, SA, Australia.

Surgical Endoscopy

|June 1, 2012

Summary

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Training on low-fidelity (FLS) laparoscopic simulators improved skill transfer more effectively than high-fidelity (LapSim) simulators. FLS-trained participants showed a greater ability to perform tasks on the LapSim simulator, indicating better skill translation.

Area of Science:

Surgical Education
Medical Simulation
Laparoscopic Skills Training

Background:

Previous studies comparing high- versus low-fidelity laparoscopic simulators lacked defined proficiency criteria, leading to mixed results.
This research addresses the need to evaluate learning outcomes based on proficiency in different simulator fidelities.

Purpose of the Study:

To determine if proficiency-based training on low-fidelity (FLS) versus high-fidelity (LapSim) laparoscopic simulators leads to different learning outcomes.
To compare the skill transferability of participants trained on either simulator type.

Main Methods:

A randomized, prospective crossover trial involving 228 participants.
Participants trained to proficiency on either LapSim or FLS simulators before crossing over to the alternate simulator for testing.

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Outcomes included crossover mean scores, proportion of tasks passed, and percentage of tasks passed.

Main Results:

Both simulator types showed increased mean crossover scores from baseline, with no significant difference between them (11.0% vs. 11.9%).
FLS-trained participants passed a significantly higher proportion of crossover tasks (0.26 vs. 0.20, p=0.016).
A significantly higher percentage of FLS-trained participants passed intracorporeal knot tying compared to LapSim-trained participants (35% vs. 8%, p<0.001).

Conclusions:

Training on both low-fidelity (FLS) and high-fidelity (LapSim) simulators is beneficial for improving laparoscopic skills.
FLS-trained participants demonstrated superior skill transferability to the LapSim simulator.
The findings suggest a potential benefit of low-fidelity simulators for developing transferable laparoscopic surgical skills.