Laparoscopic skills are difficult to learn. We, therefore, assessed the factors involved in skill acquisition, maintenance, and loss in 2 prospective, randomized studies.
In study 1, 24 laparoscopic novices were randomly assigned to a control condition who performed the laparoscopic assessment task; Massed condition who trained on virtual reality (VR) simulation during 1 day or Interval condition who had the same amount of VR training distributed over 3 consecutive days. All groups also completed a novel laparoscopic box-trainer task on 5 consecutive days. In study 2, 16 laparoscopic novices were randomly assigned to a Practice or a No-practice condition. All subjects were required to train on a VR simulation curriculum for the same duration and skill attainment level. The week after completion of training, subjects in the Practice condition were allowed 1 complete practice trial on the simulator. Both groups completed the same tasks 2 weeks after completion of the training.
In study 1, the Interval trained group showed the fastest rate of learning and on completion of training significantly outperformed both the Massed and Control groups (P < 0.0001). In study 2, both groups showed significant skills improvement from training trial T1 to T3 (P < 0.0001). The subjects in the Practice group maintained or improved their skills at 1 week but those in the No practice group showed significant decline of skills at 2 weeks after training completion (P < 0.0001).
Laparoscopic skills are optimally acquired on an Interval training schedule. They significantly decline with 2 weeks of nonuse.
In 2 prospective, randomized studies, it was shown that laparoscopic skills are optimally acquired on an interval practice training schedule and maintained with “minimal” practice. However, skills significantly decline with 2 weeks of nonuse. These results have implications for training configuration at skills centers and in vivo clinical application afterwards.
*School of Medicine, University College Cork, Cork, Ireland
†School of Psychology, Queen's University, Belfast, Northern Ireland, UK
‡Cork Cancer Research Centre, Biosciences Institute, University College Cork, Ireland.
Reprints: Anthony G. Gallagher, PhD, School of Medicine, Brookfield Health Sciences Complex, College Road, University College Cork, Ireland. E-mail: firstname.lastname@example.org
Disclosure: This research was supported with grants from the European Science Foundation to A.G.G. The authors declare no conflicts of interest.