Department of Surgery, The Royal Adelaide Hospital, Adelaide, SA, Australia.
Surg Endosc. 2012 Nov;26(11):3207-14. doi: 10.1007/s00464-012-2326-0. Epub 2012 May 31.
Previous randomized studies have compared high- versus low-fidelity laparoscopic simulators; however, no proficiency criteria were defined and results have been mixed. The purpose of this research was to determine whether there were any differences in the learning outcomes of participants who had trained to proficiency on low- or high-fidelity laparoscopic surgical simulators.
We conducted a randomized, prospective crossover trial with participants recruited from New South Wales, Western Australia, and South Australia. Participants were randomized to high-fidelity (LapSim, Surgical Science) or low-fidelity (FLS, SAGES) laparoscopic simulators and trained to proficiency in a defined number of tasks. They then crossed over to the other fidelity simulator and were tested. The outcomes of interest were the crossover mean scores, the proportion of tasks passed, and percentage passes for the crossover simulator tasks.
Of the 228 participants recruited, 100 were randomized to LapSim and 128 to FLS. Mean crossover score increased from baseline for both simulators, but there was no significant difference between them (11.0 % vs. 11.9 %). FLS-trained participants passed a significantly higher proportion of crossover tasks compared with LapSim-trained participants (0.26 vs. 0.20, p = 0.016). A significantly higher percentage of FLS-trained participants passed intracorporeal knot tying than LapSim-trained participants (35 % vs. 8 %, p < 0.001).
Similar increases in participant score from baseline illustrate that training on either simulator type is beneficial. However, FLS-trained participants demonstrated a greater ability to translate their skills to successfully complete LapSim tasks. The ability of FLS-trained participants to transfer their skills to new settings suggests the benefit of this simulator type compared with the LapSim.
先前的随机研究比较了高保真与低保真腹腔镜模拟器；然而，没有定义熟练标准，结果也不一致。本研究旨在确定在低或高保真腹腔镜手术模拟器上训练至熟练程度的参与者的学习结果是否存在差异。
我们进行了一项随机、前瞻性交叉试验，参与者来自新南威尔士州、西澳大利亚州和南澳大利亚州。参与者被随机分配到高保真（LapSim，Surgical Science）或低保真（FLS，SAGES）腹腔镜模拟器，并在规定数量的任务中训练至熟练程度。然后他们交叉到另一个保真度模拟器并进行测试。感兴趣的结果是交叉平均分数、通过任务的比例和交叉模拟器任务的通过率。
在招募的 228 名参与者中，有 100 名被随机分配到 LapSim，128 名被分配到 FLS。两个模拟器的交叉平均分数均从基线增加，但无显著差异（11.0%与 11.9%）。与 LapSim 训练的参与者相比，FLS 训练的参与者通过交叉任务的比例显著更高（0.26 与 0.20，p = 0.016）。接受 FLS 训练的参与者完成腔内打结的比例明显高于接受 LapSim 训练的参与者（35%与 8%，p < 0.001）。
从基线开始，参与者分数的相似增加表明两种模拟器类型的训练都有益。然而，FLS 训练的参与者表现出更大的能力将他们的技能转化为成功完成 LapSim 任务。FLS 训练的参与者将技能转移到新环境的能力表明该模拟器类型比 LapSim 更有益。
