Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons

Paul G. Gauger, Linnea S. Hauge, Pamela B. Andreatta, Stanley J. Hamstra, Miranda L. Hillard, Eamonn P. Arble, Steven J. Kasten, Patricia B. Mullan, Paul S. Cederna, Rebecca M. Minter

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Background: This study compares a laparoscopic skill training protocol without proficiency targets to the same protocol with explicit targets and notification of progress. Methods: Fourteen surgery interns were randomized into 2 groups. The intervention group received task-specific proficiency criteria to guide practice. The control group did not. After training, participants were evaluated by blinded faculty during laparoscopic cholecystectomy. Results: The control group met significantly fewer of the 7 LapSim (Surgical Science Sweden AB, Gotëborg) targets (mean = 1.14) than the intervention group (mean = 7.00; P = .001) and significantly fewer of the 5 video trainer targets (mean = .86) than the intervention group (mean = 5.00; P = .001). Ratings of depth perception, bimanual dexterity, efficiency, tissue handling, autonomy, and overall competence were higher for the intervention group. Effect sizes ranged from medium to large (.394-.981), indicating an impact of the proficiency-based training protocol. Conclusions: Delineation of proficiency targets with reporting of progress improves interns' practice results, and appears to have a positive effect on their early operating room (OR) performance of laparoscopic cholecystectomy.

Original languageEnglish (US)
Pages (from-to)72-80
Number of pages9
JournalAmerican journal of surgery
Issue number1
StatePublished - Jan 2010

Bibliographical note

Funding Information:
Supported by the Graduate Medical Education Innovations Fund of the University of Michigan Medical School.


  • Competency
  • Laparoscopic skills
  • Proficiency
  • Simulation
  • Targets
  • Virtual reality trainers


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