Ibrahim I Jabbour, MD, MPH, Shohan Shetty, MD, Michael Russo, MD. UT Southwestern Medical Center, Dallas, TX
Simulation training can shorten learning curves, improve technical skills, and expedite competency. Studies have shown skills learned in the simulated environment are transferable to the operating room. Residency programs are incorporating simulation into the resident curriculum to supplement the hands-on experience gained in the operating room.
One of the most widely used simulation tools is the laparoscopic box trainer (LBT). Trainees use them to practice several skills including the Fundamentals of Laparoscopic Surgery (FLS) tasks. The Ethicon TASKit trainer is one such portable LBT meant for use by trainees at home or while on a rotation where a simulation laboratory is unavailable. Portable box trainers however are expensive and not available to all residency programs. One of the more expensive and cumbersome components of the LBT setup is the installation of the web camera with its computer software.
The objective of this study was to develop and evaluate a smartphone camera setup instead of the conventional web camera for the LBT. We utilized a smartphone with either a wired or wireless connection to a monitor rather than the conventional setup. The purpose of this study was to explore resident perceptions and preferences regarding options for LBT camera setup.
Methods and procedures:
In all, 52 medical students and surgical residents with various degrees of laparoscopic experience participated in this study. Participants were instructed on setting up the LBT using the included web camera and software, and the wired and wireless (smartphone to home streaming device) configurations of the smartphone camera. Both conventional and smartphone setups utilized the same computer monitor. Participants completed a validated FLS task (peg transfer) utilizing each setup, then completed a Likert scale online questionnaire assessing comfort, effectiveness, ease of setup, practicality, image quality, and camera functionality. Statistical analysis was done using a paired t-test.
Thirty-seven novices and fifteen surgical residents volunteered to participate. All 52 participants owned a smartphone. Eighty-seven (86.5%) percent of participants believe training at home will improve their laparoscopic skills and 90.4% said they would practice at home if able. All survey parameters including comfort (3.65 vs. 4.33; p <0.05), effectiveness (3.65 vs. 4.31; p <0.05), ease of setup (3.50 vs. 4.60; p <0.05), practicality (3.52 vs. 4.60; p <0.05), image quality (3.15 vs. 4.48; p <0.05), and camera functionality (3.25 vs. 4.31; p <0.05) were in favor of the smartphone over the conventional setup. 90.4% of participants preferred the smartphone setup whereas only 5.7% preferred the conventional web camera setup. In comparison of the wired and wireless smartphone setups, 59.6% preferred wireless, 17.3% preferred wired, and the remaining 23.1% were undecided.
Both laparoscopic novices and surgical residents prefer the smartphone camera setup over the web camera for configuration of a portable LBT. A low-cost, easy-to-use portable LBT that uses a smartphone and monitor, which most learners already have at home, may be superior to conventional methods and lead to wider utilization among participants. Furthermore, the LBT without the web camera may be more affordable for residency programs.