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Authors Institution
Michael Michael
Ali Bahsoun
Saied Froghi
Kamran Ahmed
Prokar Dasgupta
Theme
Simulation
Comparing laparoscopic skill acquisition between at-home and in-Lab training, a randomised controlled trial
Background

Opportunities to acquire laparoscopic skills can be difficult and costly. Our aim was to compare an iPad tablet trainer to a laparoscopic stack and scope.

Summary of Work

Group A

The tablet trainer is comprised of an Apple iPadTM mounted on a stand, with two openings for the laparoscopic instruments to pass through.

Group B

The box trainer is comprised of a plastic manniquin linked to the VISERA Pro 'stack & scope' video system, OlympusTM.

 

Tasks

 

Task 1

Object transfer  

3 successful repeats


Task 2

Tissue cutting

2 successful repeats


Task 3

Knot tying

2 successful repeats


The domains measured for each task were Time taken and OSATS. In addition, we measured the Diameter percentage out-lie for Task 2. This invloved using the formula ((D1-D2) ÷ 3.5) x 100 = diameter percentage out-lie; where 3.5 is the diameter of the cricle drawn on the glove, D1 and D2 are the unequal diameters of the uneven circle after being cut out.

Summary of Results

Twenty two novice medical students were randomly allocated into Group A (n=11) or group B (n=11). 

  • Over the repetitions of all tasks the OSATS scores improved significantly for Group A (p<0.05).

 

  • Over the repetitions of all tasks the OSATS scores improves significantly for Group B (p<0.05) except for Task 2 (p=0.32).

 

  • Across the three repeats for Task 1, both groups significantly improvement in time taken (p<0.002) , but in Task 2 and Task 3 there was no significant improvement in both groups, p=0.09 and p=0.47 respectively.

Conclusion

The study has shown that the tablet trainer could demonstrate similar acquisition of basic laparoscopic skills to the stack and scope box trainer. 

Take-home Messages

The tablet trainer is significantly:

  • more portable
  • more cost effective than the stack and scope box trainer.

Therefore, the concept of “shifting” laparoscopic training from the ‘In-Lab’ setting to the ‘At-Home’ alternative is a practical and convenient way of training.

Acknowledgement

The author wishes to express his gratefulness to the co-authors for their contribution, encouragement and support with the whole project. Also many thanks all the participants who took part in the study trial, as well as, the Olympus simulation lab at Guy's Hospital.

References

BAHSOUN, A.N., MUNIR MALIK, M., AHMED, K., EL-HAGE, O., JAYE, P. and DASGUPTA, P. (2013) Tablet Based Simulation Provides a New Solution to Accessing Laparoscopic Skills Training. Journal of surgical education, 70(1), 161-163.

BAHSOUN, A.N., MALIK, M.M., ELHAGE, O., AHMED, K. and DASGUPTA, P. (2012) Development and validation of an iPad based laparoscopic trainer: P65. BJU international, 109(Supplement 7), 41

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Background
Summary of Work
Summary of Results
Conclusion
Take-home Messages
Acknowledgement
References
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