Effect of simulator orientation during skills training on performance of basic laparoscopic tasks by veterinary students.

OBJECTIVE To determine whether basic laparoscopic skills acquired during training in the horizontal plane would transfer to the vertical plane and vice versa. DESIGN Evaluation study. SAMPLE POPULATION 26 first- and second-year veterinary students with no prior laparoscopic skills training or surgical experience. PROCEDURES Participants were nonrandomly assigned to 2 groups. Group 1 (n = 15) underwent laparoscopic skills training in the horizontal plane, and group 2 (17) underwent laparoscopic skills training in the vertical plane. Following training, participants were tested on their ability to perform 5 laparoscopic tasks, first in the horizontal plane and then the vertical plane (group 1) or first in the vertical plane and then in the horizontal plane (group 2). All training and testing were performed with an augmented-reality laparoscopic simulator. RESULTS 3 participants in each group did not complete the study. For group 1, scores for 3 of the 5 tasks were significantly worse when tested in the vertical plane than when tested in the horizontal plane. For group 2, scores for 2 of the 5 tasks were significantly worse when tested in the horizontal plane than when tested in the vertical plane. For 3 tasks, the difference in scores for the training versus orthogonal plane was significantly lower for group 2 than for group 1. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that basic laparoscopic skills acquired in 1 plane frequently did not transfer to the orthogonal plane. Because veterinary surgeons may be required to treat patients in various positions, development of laparoscopic training models to simulate the vertical plane is recommended.