Surgical Resident Evaluations of Portable Laparoscopic Box Trainers Incorporated Into a Simulation-Based Minimally Invasive Surgery Curriculum

Introduction. Box trainers have been shown to be an effective tool for teaching laparoscopic skills; however, residents are challenged to find practice time. Portable trainers theoretically allow for extended hands on practice out of the hospital. We aimed to report resident experience with laparoscopic home box trainers. Methods. Over 2 years, all residents rotating through a minimally invasive service were given a portable trainer and access to a surgical simulation lab for practice. Each trainer contained a collapsible frame, a webcam with USB port, trocars, and laparoscopic instruments (needle driver, shears, Maryland and straight dissecting graspers) as well as Fundamentals of Laparoscopic Surgery skills testing materials. Residents were asked to log hours, usages, and their experience anonymously. Results. Twenty-three residents received a portable trainer. Fifty percent of the participants found the trainer useful or very useful, 25% said it was not useful, and 25% did not access the trainer. Those that used the trainer during their rotation did so 3.1 ± 3.0 times for 2.9 ± 3.0 hours/week. After completing their rotation, 5 of 12 residents used their trainer for an average of 10.2 ± 9.4 hours. Forty-two percent of the responders liked the accessibility of the home box trainers, while 25% criticized the camera–computer interface. Conclusions. Portable box trainers are useful and can effectively supplement a laboratory-based surgical simulation curriculum; however, personal possession of a portable simulator does not result in voluntarily long-term practice.

[1]  M. Costa,et al.  The use and effectiveness of cadaveric workshops in higher surgical training: a systematic review. , 2011, Annals of the Royal College of Surgeons of England.

[2]  Matthew D Smith,et al.  Laparoscopic simulation for all: two affordable, upgradable, and easy-to-build laparoscopic trainers. , 2013, Journal of surgical education.

[3]  G. Fried,et al.  Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. , 2004, Surgery.

[4]  T. Grantcharov,et al.  Laparoscopic performance after one night on call in a surgical department: prospective study , 2001, BMJ : British Medical Journal.

[5]  A. Supe,et al.  Ergonomics in laparoscopic surgery , 2010, Journal of Minimal Access Surgery.

[6]  H. Bonjer,et al.  Voluntary autonomous simulator based training in minimally invasive surgery, residents' compliance and reflection. , 2012, Journal of surgical education.

[7]  Robert V Rege,et al.  Effect of sleep deprivation on the performance of simulated laparoscopic surgical skill. , 2003, American journal of surgery.

[8]  David A Cook,et al.  State of the Evidence on Simulation-Based Training for Laparoscopic Surgery: A Systematic Review , 2013, Annals of surgery.

[9]  D. Dinges,et al.  Behavioral and physiological consequences of sleep restriction. , 2007, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[10]  G. Fried,et al.  Evaluating laparoscopic skills , 2003, Surgical Endoscopy And Other Interventional Techniques.

[11]  Kanav Kahol,et al.  Impact of fatigue on neurophysiologic measures of surgical residents. , 2011, Journal of the American College of Surgeons.

[12]  F. Lewis,et al.  Issues in general surgery residency training--2012. , 2012, Annals of surgery.

[13]  J. Korndorffer,et al.  Proficiency maintenance: impact of ongoing simulator training on laparoscopic skill retention. , 2005, Journal of the American College of Surgeons.

[14]  Dimitrios Stefanidis,et al.  Simulator Training to Automaticity Leads to Improved Skill Transfer Compared With Traditional Proficiency-Based Training: A Randomized Controlled Trial , 2012, Annals of surgery.

[15]  G. Fried,et al.  Proving the Value of Simulation in Laparoscopic Surgery , 2004, Annals of surgery.

[16]  Data-based self-study guidelines for the fundamentals of laparoscopic surgery examination , 2012, Surgical Endoscopy.

[17]  James R Korndorffer,et al.  Effective home laparoscopic simulation training: a preliminary evaluation of an improved training paradigm. , 2012, American journal of surgery.

[18]  Leif Hedman,et al.  Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. , 2007, American journal of surgery.

[19]  Daniel J Scott,et al.  Maintaining proficiency after fundamentals of laparoscopic surgery training: a 1-year analysis of skill retention for surgery residents. , 2009, Surgery.

[20]  Melina C Vassiliou,et al.  Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. , 2010, American journal of surgery.

[21]  G. Fried,et al.  FLS simulator performance predicts intraoperative laparoscopic skill , 2007, Surgical Endoscopy.

[22]  A. Darzi,et al.  Effect of sleep deprivation on surgeons' dexterity on laparoscopy simulator , 1998, The Lancet.

[23]  L. Stewart,et al.  Bringing the skills laboratory home: an affordable webcam-based personal trainer for developing laparoscopic skills. , 2011, Journal of surgical education.

[24]  J. Kaouk,et al.  THE SURGICAL LEARNING CURVE FOR LAPAROSCOPIC COMPARED TO OPEN RADICAL PROSTATECTOMY , 2009 .

[25]  Adam Dubrowski,et al.  Teaching Surgical Skills: What Kind of Practice Makes Perfect?: A Randomized, Controlled Trial , 2006, Annals of surgery.

[26]  Andrew J Vickers,et al.  The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study. , 2009, The Lancet. Oncology.

[27]  Elspeth M McDougall,et al.  The EZ Trainer: validation of a portable and inexpensive simulator for training basic laparoscopic skills. , 2008, The Journal of urology.