Effects of Systematically Guided vs. Self-Directed Laparoscopic Box Training on Learning Performances: An Observational Study

Abstract

Introduction

Minimally invasive surgery is increasing in all fields of surgery. It is currently unknown whether structured training is superior to self-directed training. The aim of this study is to analyze the enhancement of surgical skills in laparoscopy box trainers in a systematically guided training program compared to self-directed training.

Material and Methods

Two groups of 40 medical students were included in the study between 04/2021 and 01/2023. Each training session on the laparoscopic box trainer (Medishield BV, NL) was automatically protocolled, including time, force, and path length. The structured group consisted of 21 students working in peer tandem, while the self-directed group consisted of 19 last-year students in their four-month elective. The observational study was conducted in an ecological study design.

Results

The self-directed cohort completed an average of 15 training sessions compared to the structured cohort’s 10 sessions. All participants in both groups improved in time, path length, and force. The structured cohort showed nearly linear improvement, while the self-directed cohort had high deviation in results.

Conclusion

Supervision and collaborative work positively influence laparoscopic training success. Mere availability of training does not exploit the potential of laparoscopic box trainers. Curriculums for young surgeons or medical students should include institutionalized training with a structured schedule and a training partner for improved outcomes.

Zusammenfassung

Einleitung

Minimalinvasive Interventionen werden zunehmend in allen Gebieten der Chirurgie durchgeführt. Noch unbekannt ist aber, ob ein strukturiertes Training zu besseren Ergebnissen führt als ein selbstgeleitetes Training. Ziel der Studie war es, zu untersuchen, ob sich die chirurgischen Fähigkeiten nach einer Ausbildung am laparoskopischen Boxtrainer mit einem systematischen Trainingsprogramm im Vergleich zu einem selbstgeleiteten Training verbessern.

Material und Methoden

Zwischen 04/2021 und 01/2023 wurden insgesamt 40 Medizinstudenten und -studentinnen in die Studie aufgenommen und in 2 Gruppen unterteilt. Jede Trainingseinheit mit dem laparoskopischen Boxtrainer (Medishield BV, NL) wurde automatisch protokolliert, einschließlich der aufgewendeten Zeit, der Krafteinwirkung und der Weglänge. Die strukturierte Gruppe bestand aus 21 Studierenden, die im Tandem mit gleichrangigen Studierenden arbeiteten. Die selbstgeleitete Gruppe bestand aus 19 PJ-Studierenden in ihrem gynäkologischen Wahltertial. Die Beobachtungsstudie wurde als ökologische Studie konzipiert und durchgeführt.

Ergebnisse

Die selbstgeleitete Kohorte führte durchschnittlich 15 Trainingseinheiten durch verglichen mit den 10 Trainingseinheiten der strukturierten Kohorte. Bei allen Teilnehmern aus beiden Gruppen gab es Verbesserungen hinsichtlich der Zeit, der Weglänge und der Krafteinwirkung. Die Verbesserungen in der strukturierten Kohorte waren fast linear, wohingegen es große Schwankungen in den Ergebnissen der selbstgeleiteten Kohorte gab.

Schlussfolgerung

Training unter Aufsicht und kollaboratives Arbeiten haben positive Auswirkungen auf den Erfolg von laparoskopischem Training. Die Verfügbarkeit von Trainingsmöglichkeiten allein schöpft aber das Potenzial von laparoskopischen Boxtrainern nicht aus. Die Ausbildung von Weiterbildungsassistentinnen und -assistenten und von Medizinstudierenden kann mit einem Programm, in dem strukturiert Trainingszeit eingeräumt und mit einem Partner trainiert wird, verbessert werden.

Keywords

laparoscopy - box training - learning performance - surgical education - structured training

Schlüsselwörter

Laparoskopie - Boxtraining - Lernleistung - chirurgische Ausbildung - strukturiertes Training

Publication History

Received: 29 August 2024

Accepted after revision: 14 September 2024

Article published online:
06 December 2024

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