LaparoscopiesDevelopment of a Model for Training and Evaluation of Laparoscopic Skills 1
Section snippets
Materials and Methods
The McGill Laparoscopic Simulation study involved 42 examinees (volunteers) in total. There were 6 residents from each of the 5 years of the general surgery residency program, 6 practicing laparoscopic surgeons, and 6 attending surgeons who do not practice laparoscopy. It was required that each examinee complete seven exercises in turn and then repeat them. The simulator consists of a laparoscopic trainer box measuring 40 × 30 × 19.5 cm (USSC Laptrainer, United States Surgical Corporation,
Statistics
The overall data were analyzed with analysis of variance (ANOVA) to test for the effects of level of training and repetition (and their interaction) on performance. Linear regression analysis was used to relate total performance scores and timing scores for each task to residents’ level of training. Correlation coefficients were calculated. Student’s t-test was used to test differences between laparoscopic and nonlaparoscopic attending surgeons, nonlaparoscopic surgeons versus PGY5 residents,
Results
The effect of level of training on performance was evaluated by ANOVA with repeated measures and was found to be a significant predictor of performance (P = 0.002). Linear regression analysis was used to correlate level of training with performance for each task individually. Overall four out of seven tasks (1, 2, 6, 7) showed a significant correlation (P <0.05) between PGY level and total scores. Table Isummarizes the correlation coefficients and P values for all seven exercises.
Timing score
Comments
Laparoscopic simulators have been used primarily as practicing tools. The simulator initially was constructed as a training model to assist surgeons in the development of coordination prior to application of a procedure in experimental animals.[4]Although not specifically designed to simulate a specific surgical operation, the laparoscopic trainer provides fundamental training for most laparoscopic skills used in the majority of surgical operations. In addition, many surgeons may not have
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This work was supported by an educational grant from United States Surgical Corporation (Auto Suture Canada).