Yaoyu Fu1, Lora Cavuoto, PhD1, Di Qi, PhD2, Karthikeyan Panneerselvam2, Venkata S Artikala, PhD3, Andinet Enquobahrie, PhD3, Suvranu De, PhD2, Steven D Schwaitzberg, MD1. 1University at Buffalo, 2Rensselaer Polytechnic Institute, 3Kitware, Inc.
Introduction: The virtual basic laparoscopic skill trainer suturing simulator (VBLaST-SS©) was developed to simulate the intracorporeal suturing task in the FLS program. The purpose of this study was to evaluate the training effectiveness and participants’ learning curve on the VBLaST-SS© and to assess whether the skills acquired on the VBLaST-SS© transfer to the FLS trainer box (and vice versa).
Methodsand Procedures: Fourteen first to third year medical students were randomly assigned to two training groups (7 per group): VBLaST or FLS, based on the modality of training. After a baseline test on both systems, participants practiced on their assigned system for one session a day, five days a week for three consecutive weeks. In each training session, they practiced 30 minutes or up to 10 trials. After the last training session, participants performed the intracorporeal suturing task on both systems as their post-test performance test. They then came back two weeks later to perform on both systems for skill retention assessment.
Participants’ performance scores were calculated based on the original FLS scoring system. The cumulative summation (CUSUM) method was used to evaluate learning. Two-way mixed factorial ANOVA was used to compare the effects of group, time point (baseline, post-test, and retention), and their interaction on performance.
Results: Based on the learning curve (shown in the figure below), after 7 days of training, most of the participants in each group reached the predefined proficiency level. The two-way mixed factorial ANOVA showed that there was a significant difference between time points within assigned training groups (p<0.001), however, the group (p=0.421) and group × time interaction (p=0.091) were not significant. Within participants’ assigned group, there was a significant difference between baseline and post-test (p<0.001), but no significant difference between post-test and retention (p=0.316), which indicates that skill acquired on both the FLS and the VBLaST-SS© retained at the retention session.
The CUSUM learning curve shows that, using the proficiency criteria score of 280.8, one participant in each group achieved the 5% failure rate during the training period (at trial 101 for the FLS group and at trial 129 for the VBLaST group). Thirteen out of fourteen participants’ CUSUM curves showed a negative trend during the training period, which indicates a trend toward achieving the 5% failure rate after further training.
Conclusion: The VBLaST-SS© is effective in training laparoscopic suturing skill. Participants’ performance of intracorporeal suturing increased significantly after training on both systems.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 92893
Program Number: S010
Presentation Session: Education
Presentation Type: Podium
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