Remote training in laparoscopy: a randomized trial comparing home-based self-regulated training to centralized...

Area of Science:

• Surgical Education
• Medical Simulation
• Laparoscopic Training

Background:

• Simulation-based surgical training (SBST) is crucial for developing surgical expertise.
• Proficiency-based training (PBT) in laparoscopy shows promise for skills transfer but faces barriers like time constraints and limited distributed training.
• Home-based training presents a potential solution to these limitations.

Purpose of the Study:

• To compare the effectiveness of centralized instructor-regulated training (CIRT) versus home-based self-regulated training (HSRT) for laparoscopic skills acquisition.
• To evaluate performance improvements, training time, and retention in surgical trainees using PBT models.

Main Methods:

• First-year surgical trainees were randomized to CIRT or HSRT using portable box trainers and Fundamentals of Laparoscopic Surgery (FLS) exercises.
• HSRT involved home-based training with online materials, while CIRT included in-person simulation center sessions.
• Performance was assessed via hand-eye coordination, bimanual coordination, suture/knot-tying, and FLS tests.

Main Results:

• Passing rates were high in both groups (87% CIRT, 96% HSRT).
• Both training methods led to significant improvements in task times and comparable performance at posttest and 6-month retention.
• HSRT facilitated distributed training with varied training times, showing no significant inter-group performance differences.

Conclusions:

• Home-based self-regulated training (HSRT) is a feasible and effective alternative to centralized instructor-regulated training (CIRT) for laparoscopic skills.
• Comparable performance outcomes suggest HSRT can be successfully implemented within a supportive instructional design.
• Further research is recommended to explore trainee preferences and optimize HSRT implementation.