Master and Apprentice or a Slave to Technology? A Randomized Controlled Trial of Minimal Access Surgery...

Area of Science:

• Surgical Education
• Medical Simulation
• Minimal Access Surgery (MAS)

Background:

• Simulation-based training is crucial for developing proficiency in minimal access surgery (MAS).
• Evaluating different training modalities, including physical and virtual simulators, is essential for optimizing surgical education.
• Novice surgeons require effective methods to acquire fundamental MAS technical skills.

Purpose of the Study:

• To compare the efficacy of consultant-led, self-directed physical simulation, and virtual simulation training for MAS novices.
• To assess the impact of different training approaches on performance in validated surgical tasks.

Main Methods:

• A randomized controlled trial involving 32 novice medical students was conducted.
• Participants were allocated to four groups: consultant-led physical simulation, self-directed physical simulation, self-directed virtual simulation, and a control group.
• Performance on 'ring transfer' and 'needle pass' tasks was assessed pre- and post-intervention using blinded expert evaluation.

Main Results:

• Both consultant-led and self-directed physical simulation groups showed significant improvement in the 'ring transfer' task.
• No significant improvement was observed in the virtual simulation or control groups for the 'ring transfer' task.
• None of the groups demonstrated statistically significant improvement in the more complex 'needle pass' task.

Conclusions:

• Physical simulator practice, regardless of supervision, enhances novice performance on basic MAS tasks.
• Virtual simulation did not yield comparable skill improvements for the tested tasks.
• Training time on physical simulators appears more critical than supervision for simple MAS skill acquisition.