Cara B Jones, Sophia McKinley, MD, EdM, Christina Valle, CST, RN, Denise W Gee, MD, James Titus, Roy Phitayakorn, MD, MHPE, MEd, Emil Petrusa, PhD, Daniel A Hashimoto, MD, MS. Massachusetts General Hospital, Department of Surgery
Introduction: Traditional laparoscopic box trainers are important in laparoscopic training; however, they are expensive and not easily portable. Low cost trainers can be developed from common household materials, and we constructed the Twelve Pack Box Trainer using an empty box of soda and either a Samsung Galaxy S6 or an iPhone 6 as both the camera and screen. Previous studies evaluating low cost trainers have not compared resident performance to standard trainers. This study tested resident performance of the FLS peg transfer task on the Twelve-Pack Box (TPB) trainer vs. the standard FLS box.
Methods: Ten residents were asked to perform the Peg Transfer task twice consecutively on both the standard FLS trainer and the TPB Trainer for a total of 4 repetitions. Half used FLS box first while the other used the TPB trainer first before crossing over the other trainer. Each repetition was timed with a stopwatch. Afterwards, residents were asked to complete an online survey about the two trainers. Using a Likert Scale, residents rated their comfort performing the Peg Transfer, the screen resolution, size, and overall opinion of the Twelve-Pack Box Trainer.
Results: Ten residents (PGY1: 6, PGY2: 1, PGY3: 3) participated; three were FLS certified. Median peg transfer time on the FLS trainer (63.5 sec, IQR: 57.5-72.5) was significantly lower than on the TPB trainer (114.5 sec, IQR: 95.5-155) (p<0.001). There was no significant difference in total errors between the two trainers (p=0.3). FLS certified residents were significantly faster than non-FLS certified residents on both trainers (p<0.01). All residents felt the task was more difficult on the TPB trainer with 30% stating the TPB trainer was less comfortable to use, and 60% stating the screen was too small. Most residents felt the TPB trainer adequately portrays the 3D space in 2D well (70%) and mimics the fulcrum effect of laparoscopy (90%). Half of the residents responded that they would use the TPB trainer at home.
Conclusion: The TPB Trainer, while cost efficient and effective in simulating effects of laparoscopy, was more difficult for residents to use than the standard FLS trainer, likely due to the small size of the smartphone screen. With only half of residents willing to use it as a take home simulator, other low-cost options should be explored to improve access to simulation outside the hospital for residents.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86893
Program Number: P323
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster