Study protocol for a randomized controlled trial on a multimodal training curriculum for laparoscopic cholecystectomy – LapTrain

Background

Although minimally invasive surgery (MIS) has replaced many open procedures in visceral surgery, technical and psychomotor obstacles remain a constant challenge for surgeons and trainees. However, there are various training curricula enabling surgeons to acquire the visuospatial and psychomotor abilities additionally required when performing MIS. Currently accepted training modalities include box-trainers, organ and animal models as well as completely simulated training environments, realized in virtual reality (VR) trainers. All of these methods facilitate an adequate training prior to patient contact, so patient safety can benefit as well. This study aims to evaluate the benefit of a structured multi-modality laparoscopy training curriculum.

Methods

Junior and senior surgical residents are included (n = 60). Groups are stratified with concern to previous experience and training of participants. The training curriculum consists of a standardized sequence of available modalities and exercises on box- and VR-trainers. Specific consideration applies to the training effect during the repeated performance of a laparoscopic cholecystectomy (LC) between intervention (training in between LCs) and control group (no training in between LCs). Analysis of training effects is performed using a cadaveric model for LC and objectified using the validated scoring system Global Operative Assessment of Laparoscopic Skills (GOALS).

Discussion

This study assesses the value of a multimodal training platform in medical education and postgraduate training and aims at illustrating possible guidelines when establishing such a curriculum. Possible factors of influence, such as varying backgrounds, learning motivation and –success among participants are explored in the data analysis and add beneficially to further evaluating the efficacy of such training to more heterogeneous participant groups like medical students and other professionals.