Retention of laparoscopic psychomotor skills after a structured training program depends on the quality of the training and on the complexity of the task

Abstract

This follow-up RCT was conducted to evaluate laparoscopic psychomotor skills retention after finishing a structured training program. In a first study, 80 gynecologists were randomly allocated to four groups to follow different training programs for hand-eye coordination (task 1) with the dominant hand (task 1-a) and the non-dominant hand (task 1-b) and laparoscopic intra-corporeal knot tying (task 2) in the Laparoscopic Skills Testing and Training (LASTT) model. First, baseline skills were tested (T1). Then, participants trained task 1 (G1: 1-a and 1-b, G2: 1-a only, G3 and G4: none) and then task 2 (all groups but G4). After training all groups were tested again to evaluate skills acquisition (T2). For this study, 2 years after a resting period, 73 participants were recruited and tested again to evaluate skills retention (T3). All groups had comparable skills at T1 for all tasks. At T2, G1, G2, and G3 improved their skills, but the level of improvement was different (G1 = G2 > G3 > G4 for task 1; G1 = G2 = G3 > G4 for task 2). At T3, all groups retained their task 1 skills at the same level than at T2. For task 2, however, a skill decay was already noticed for G2 and G3, being G1 the only group that retained their skills at the post-training level. Training improves laparoscopic skills, which can be retained over time depending on the comprehensiveness of the training program and on the complexity of the task. For high complexity tasks, full training is advisable for both skills acquisition and retention.

Keywords: Intra-corporeal knot tying; LASTT model; Laparoscopy; Psychomotor; Skills acquisition; Skills retention; Training.

Fig. 1

Flowchart of participation. HEC ham-eye coordination, DH dominant hand, NDH non-dominant hand, LICK laparoscopic intra-corporeal knot tying

Fig. 2

Skills for hand-eye coordination with the dominant hand (task 1-a). Participants were randomly allocated to different groups according to the training program (G1, G2, G3, and G4), and the skills were measured before training to evaluate the baseline levels (T1), immediately after training to evaluate skills acquisition (T2), and 2 years later to evaluate skills retention (T3). Median (interquartile range) scores are presented

Fig. 3

Skills for hand-eye coordination with the non-dominant hand (task 1-b). Participants were randomly allocated to different groups according to the training program (G1, G2, G3, and G4), and the skills were measured before training to evaluate the baseline levels (T1), immediately after training to evaluate skills acquisition (T2), and 2 years later to evaluate skills retention (T3). Median (interquartile range) scores are presented

Fig. 4

Skills for laparoscopic intra-corporeal knot tying (task 2). Participants were randomly allocated to different groups according to the training program (G1, G2, G3, and G4), and the skills were measured before training to evaluate the baseline levels (T1), immediately after training to evaluate skills acquisition (T2), and 2 years later to evaluate skills retention (T3). Median (interquartile range) scores are presented