Randomized controlled trial on the effect of coaching in simulated laparoscopic training

Area of Science:

• Surgical Education
• Medical Simulation
• Laparoscopic Surgery Training

Background:

• The impact of coaching on surgical skill acquisition in simulation is not well understood.
• This study aimed to compare structured coaching versus self-directed learning in laparoscopic surgery simulation.

Purpose of the Study:

• To evaluate the effectiveness of structured coaching on surgical quality and understanding in simulated laparoscopic surgery.
• To compare the learning curves and proficiency gains between coached and uncoached trainees.

Main Methods:

• Seventeen medical students performed 10 virtual reality laparoscopic cholecystectomies.
• Participants were randomized into structured coaching or no-training control groups.
• Surgical quality (Competency Assessment Tool), strategic understanding, and performance metrics were assessed.

Main Results:

• The coached group demonstrated significantly higher surgical quality and understanding at multiple time points.
• The intervention group achieved competency in error reduction by operation 7, while the control group did not plateau.
• Manual skill metrics (path length, movements) were similar; operation time was shorter in the control group.

Conclusions:

• Structured coaching significantly enhances clinically relevant surgical proficiency, including error reduction and strategic understanding.
• Manual dexterity skills are primarily improved through repetition, independent of coaching.
• Coaching is a crucial element for acquiring complex procedural skills in surgical simulation.