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Variable practice is superior to self-directed training for laparoscopic simulator training: a randomized trial.

Anishan Vamadevan1, Lars Konge2,3, Flemming Bjerrum2,3,4

  • 1Copenhagen Academy for Medical Education and Simulation, University of Copenhagen and Centre for HR and Education, Capital Region, Ryesgade, 53B, 2100, Copenhagen, Denmark. anishan.vamadevan@regionh.dk.

Surgical Endoscopy
|February 6, 2024
PubMed
Summary
This summary is machine-generated.

Variable practice in laparoscopic surgery training significantly improves skill acquisition and retention. This method is more effective than self-directed training for developing surgical proficiency and ensuring long-term skill retention.

Keywords:
Cognitive loadFeedbackLaparoscopyProficiencyRetentionSimulationSkills acquisitionTransferVariable practice

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Area of Science:

  • Surgical Education
  • Medical Simulation
  • Psychomotor Skill Development

Background:

  • Mastering laparoscopic surgery requires specialized psychomotor skills that are challenging to acquire safely in an operating room setting.
  • Proficiency-based training programs utilizing virtual reality simulators offer a safe environment for novices to develop essential surgical skills.
  • Variable practice has been shown to enhance skill retention and transfer in non-surgical contexts.

Purpose of the Study:

  • To investigate whether variable practice is superior to self-directed training in proficiency-based laparoscopic simulator training.
  • To evaluate the impact of variable practice on the time to proficiency, skill transfer, and retention of laparoscopic basic skills.

Main Methods:

  • A randomized trial involving 36 participants undergoing proficiency-based laparoscopic simulator training for basic skills.
  • Participants were assigned to either a variable practice group or a self-directed training group.
  • Training was followed by a transfer test on a procedural task (salpingectomy) and a retention test after 3-5 weeks.

Main Results:

  • The variable practice group achieved proficiency faster in basic skills (119 min vs. 182 min, p=0.015).
  • Participants in the variable practice group reached proficiency more quickly in the transfer test (103 min vs. 183 min, p<0.001) and retention test (51 min vs. 109 min, p<0.001).

Conclusions:

  • Variable practice is a superior training method compared to self-directed training for proficiency-based laparoscopic skills.
  • Variable practice reduces the time to achieve proficiency, enhances transfer to procedural tasks, and improves skill retention.