Effect of spaced training with a box trainer on the acquisition and retention of basic laparoscopic skills

To investigate whether basic laparoscopic skills acquired via structured spaced training on a box trainer persist after 6 months.

In a prospective study undertaken at the Ege University School of Medicine (Izmir, Turkey) between January 1, 2012, and June 1, 2013, 22 gynecology residents without previous laparoscopy experience were randomly assigned (1:1) to receive training with a box trainer (1 hour per week for 4 weeks) or to a control group. At baseline and at 5 weeks, residents' performance was assessed via the salpingectomy module of LapSim. The box trainer group was reassessed for skills retention 6 months later.

The box trainer group performed significantly better than the control group in time (P=0.01) and economy of movement (P=0.001) at the final test. Error scores did not differ significantly. Deterioration between final and retention tests in the box trainer group were recorded in time (P=0.041), instrument path length (P=0.013), and instrument angular path (P=0.075). However, time and economy of movement scores were better at the retention assessment than at baseline (P=0.008 and P=0.003, respectively).

Structured training with a box trainer improved laparoscopic skills, but deterioration was evident within 6 months. This deterioration should be considered when planning laparoscopic training programs.