Assessing the Efficacy of Enhanced Versus Standard Three-Dimensional Training Models in Laparoscopic Skills Acquisition: A Randomized Controlled Trial of Novice Medical Students

Objective

The aim of the study was to determine if laparoscopic skills acquisition will be superior with the use of 3D-enhanced training models with increased dimensionality and spatial complexity compared to standard 3D LapPass training models in novice medical students. We hypothesized that adopting low-fidelity, 3D-enhanced training models in the 2D visual modality may expedite adaptation to monocular cues related to depth perception, enhancing performance.

Design

A prospective, single-center, 2-arm, randomized controlled trial with participants randomized equally into either 3D-enhanced or standard 3D group (allocation ratio 1:1, block sizes 2 and 4) performing 2 standardized laparoscopic tasks: (1) polo grasping and manipulation and (2) intracorporeal suturing. Performance was assessed using the Global Operative Assessment of Laparoscopic Skills (GOALS) tool, completion time, and number of errors, with evaluations at baseline, interim, and post-training for each task. A post-study survey measured participant-perceived confidence and performance (ID: NCT06184854).

Setting

Barts Cancer Institute, Queen Mary University of London, UK.

Participants

Sixty-five medical students, all novices in laparoscopic surgery, were enrolled, with 3 dropouts.

Results

Thirty-one participants in each group completed the study with homogeneity regarding demographic data (p > 0.05). Both groups had significantly superior performance post-training compared to baseline in the 2 tasks (intragroup comparison, p < 0.017). In the intergroup comparison, the 3D-enhanced group had statistically significantly greater improvements in the GOALS score parameter and depth perception domain across all comparisons for both tasks (p < 0.05). Time improvement and error reduction also favored the 3D-enhanced group, however, without reaching statistical significance. In the post-study survey, the 3D-enhanced group reported significantly greater perceived post-training confidence and performance in the suturing task alone (p < 0.05).

Conclusions

The use of 3D-enhanced training models resulted in superior laparoscopic skills acquisition for novices in 2 tasks compared to standard 3D LapPass models. Therefore, incorporating 3D-enhanced models into laparoscopic training curricula alongside standard 3D LapPass models can supplement learning. Further work should focus on long-term efficacy with a competency-based endpoint.