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Knowledge Acquisition, Self-Assessed Competence, and Simulator-Based Performance in a Structured Laparoscopic VR
Antoni Sierant1, Julia Bijok1, Michal Pirozynski1
1Centre for Endoscopy Simulation, Centre of Postgraduate Medical Education, Warsaw, Poland.
Introduction:
Simulation enables safe, structured practice of laparoscopic skills outside the operating room, yet objective, threshold-referenced performance data from mandatory postgraduate curricula in Central and Eastern Europe remain scarce. We report the educational outcomes of a structured, multi-level virtual-reality (VR) laparoscopy curriculum delivered at a single national simulation center.
Methods:
We conducted a single-center prospective observational study of 29 obstetrics and gynecology residents who completed a four-module laparoscopic course (Basic 1-2, Advanced 1-2) at the Centre for Endoscopy Simulation, Centre of Postgraduate Medical Education (CMKP), Warsaw. Outcomes comprised pre- and post-course single-choice knowledge tests, self-assessed competence, satisfaction, and simulator-based performance evaluated against a priori, criterion-referenced passing thresholds. Technical metrics were simulator-generated (Simbionix LAP Mentor); no human global rating scales were used. Demographic and training-related variables (gender, residency year, training-center referral level, prior endoscopic experience) were analyzed with non-parametric statistics.
Results:
Knowledge scores improved from 20.9 (SD = 2.70) to 29.2 (SD = 1.01) (Wilcoxon, p <0.05). Self-assessed competence increased significantly across all domains (p <0.05). Satisfaction was uniformly high (mean 4.7/5, SD = 0.45) but did not correlate with objective performance (all p >0.05). Outcomes did not differ by gender or training-center referral level; residency year was associated with performance only in colpotomy (ρ = -0.37, p =0.047), and prior experience predicted performance mainly in basic camera manipulation (e.g. 30° navigation distance, ρ = -0.50, p =0.005), consistent with a learning-curve effect.
Conclusion:
A structured, multi-modular VR laparoscopy course significantly improved theoretical knowledge and self-assessed competence among OB-GYN residents. Within this single-center cohort, measured outcomes did not differ by gender or training-center referral level. High satisfaction diverged from objective performance, underscoring the need for balanced, criterion-referenced evaluation. A priori passing thresholds enabled transparent, proficiency-oriented assessment.
