Faculty Collaboration Database

The impact of training under different visual-spatial conditions on reverse-alignment laparoscopic skills development. Surg Endosc 2012 Jan;26(1):120-3

Date

08/23/2011

Pubmed ID

21858581

DOI

10.1007/s00464-011-1836-5

Scopus ID

2-s2.0-84857418205 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

BACKGROUND: Circumstances may arise during laparoscopic procedures in which alignment of the laparoscope and the instruments is off by 180°, creating a mirror image of the operative field. It has been shown that task performance is degraded under these reverse-alignment conditions, and that the magnitude of performance impairment is directly related to laparoscopic experience and skill. The aim of this study was to determine if reverse-alignment surgical skills could be developed through training.

METHODS: Twenty-two medical students were randomized to train in either reverse- or forward-alignment conditions on a standardized laparoscopic task in a video trainer (peg transfer). Baseline scores were attained for each group under both orientations. Subjects participated in three 1-h training sessions during an 8-week period. Post-training scores were then obtained under both alignment conditions. Pre and post-training scores were compared for users in each study group under both conditions.

RESULTS: Post-training assessments in the forward orientation demonstrated that subjects in the forward-training group improved significantly compared to pre-testing, while the performance of subjects in the reverse-training group did not improve. Under reverse-alignment conditions, both groups improved on post-test assessment, with dramatic improvements observed for those in the reverse-training group.

CONCLUSIONS: Laparoscopic novices can learn to adapt to a sensorimotor discordance in a simulated training environment. While it is possible that skills developed by training under standard forward-alignment conditions can be utilized in situations of extreme visual-spatial discordance, the intentional development of reverse-alignment skills by training under these conditions may prove beneficial to novice surgeons.

Author List

Holznecht C, Schmidt T, Gould J

Author

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Clinical Competence
Computer Simulation
Education, Medical, Undergraduate
Humans
Laparoscopy
Orientation
Psychomotor Performance
Space Perception
Task Performance and Analysis
Teaching
Video Recording
Wisconsin