Development of laparoscopic skills in skills-naïve trainees using self-directed learning with take-home laparoscopic trainer boxes.

BACKGROUND

To determine if take home laparoscopic trainer boxes with only self-directed learning can develop laparoscopic skills in surgically naive learners.

METHODS

74 starting PGY1 OB/Gyn residents and OB/Gyn clerkship medical students volunteered for the study. Learners performed a laparoscopic peg transfer task with only task instructions and no additional training. Initial tasks were recorded and scored. The participants took home a laparoscopic trainer box for 3 weeks to practice without guidance and returned to perform the same task for a second/final score. Initial and final scores were compared for improvement. This improvement was compared to practice and variables such as demographics, surgical interest, comfort with laparoscopy, and past experiences.

RESULTS

Mean peg transfer task scores improved from 287 (SD = 136) seconds to 193 (SD = 79) seconds ( < 0.001). Score improvement showed a positive correlation with number of home practice sessions with a linear regression R of 0.134 ( = 0.001). More practice resulted in larger increases in comfort levels, and higher comfort levels correlated with better final task scores with a linear regression R of 0.152 ( < 0.001). Interest in a surgical specialty had no impact on final scores or improvement. Playing a musical instrument and having two or more dexterity-based hobbies was associated with a better baseline score ( = 0.032 and  = 0.033 respectively), but no difference in the final scores or score improvement. No other past experiences impacted scores.

CONCLUSIONS

Our study demonstrates that the use of home laparoscopic box trainers can develop laparoscopic skills in surgical novices even without formal guidance or curriculum.