Retention of Laparoscopic and Robotic Skills 12 Weeks After Simulation Training

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Abstract

BACKGROUND:

Although minimally invasive simulation modeling provides a supplement for traditional surgical training, there is less objective data on longer-term skills retention.

METHODS:

We present the second stage of a randomized single-blinded controlled trial in which 40 simulation-naive medical students were randomly assigned to practice pegboard transfer tasks on either laparoscopic (N=20, Fundamentals of Laparoscopic Surgery, VT Medical Inc., Waltham, MA) or robotic (N=20, dV-Trainer, Mimic, Seattle, WA) platforms. In the first stage, two expert surgeons evaluated participants on both tasks immediately after training using previously validated global rating scales of laparoscopic operative performance. In the second stage, participants were evaluated on both tasks 12 weeks after training.

RESULTS:

Of the 40 participants who participated in the initial training phase, 23 (11 laparoscopic and 12 robotic) underwent repeat evaluation. Twelve weeks after training, there were no significant differences between groups in objective measures or global rating scale composite scores for the laparoscopic task. However, the robotic practice group demonstrated significantly higher global rating scale composite scores on the robotic simulation task (11.8 versus 9.4, P=.04). Robotic training was associated with improved economy of motion (P=.017) and fewer ring drops (P=.018) on the robotic platform.

DISCUSSION:

Robotic skills acquired through simulation appear to be easier to maintain than laparoscopic skills gained via simulation.

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