Basic laparoscopic skills retention and transfer after high fidelity simulation training: a prospective comparative study

Background: Simulation in laparoscopic training has gained wide acceptance but long-term retention after basic skills training for novices has seldom been explored, and transfer to more complex surgical interventions remains controversial. Objective: To assess (i) skills retention at more than six months after initial training and (ii) skills transfer to a simulated surgical procedure. Methods: Prospective comparative study of simulated surgical training. Nine six-year medical students had two training sessions on the Simbionix LAP Mentor™'s "basic skills". They completed a 4-task workshop six months later as well as a cholecystectomy module. For the latter, their results were compared to those of another group of 9 participants who had never trained on laparoscopic simulation. Evaluation was assessed by the Objective Structured Assessment of Technical Skills (OSATS) global rating scale and by LAP Mentor™'s metrics. Results: For basic skills training, the median OSATS score improved from 17 (10-21) during the first session to 25 (2-27) in the second one (p=0.009), remaining at 24 (19-26) in the third session 6 months later. These results were consistent with metrics scores such as total time and path length of instruments. As regards completion of the cholecystectomy, median OSATS scores were comparable between trained and novice participants (21 vs. 23), and LAP Mentor™'s metrics even showed a tendency towards better performance for novices. Conclusions: Laparoscopic high fidelity simulation seems efficient for long-term retention even after short training, but has not proved to be effective on skills transfer to more complex surgical procedures for non-experienced students.