Presentation
A Comparative Analysis Between Medical and Non-Medical Students in Laparoscopic Skill Development
DescriptionIntroduction: In the surgical field, the development of precise motor skills is crucial for successful patient outcomes. Minimally invasive procedures, such as laparoscopic surgery, require surgeons to overcome challenges like motion inversion, fulcrum effect and limited degree of freedom of instrument manipulation. The Fundamentals of Laparoscopic Surgery (FLS) program was established to ensure that surgeons acquire these essential skills before proceeding to perform actual surgeries. Medical students must complete FLS training course with hands-on simulation training and demonstrate proficiency in specific surgical skills to receive board certification.
Substantial research has been devoted to accelerating skill acquisition from medical training, often based on convenient samples as opposed to medical professionals or trainees (Akand et al., 2016; Ali et al., 2002; Furer et al., 2016). This article compares motor skill development between medical students and non-medical college students practicing the FLS peg transfer task under near-identical experimental setups and procedures across two experiments. The goal is to examine whether skill development patterns differ between the two groups, thereby providing empirical evidence on what data collected from non-medical students can be generalized to medical students in the context of laparoscopic surgery training. These findings will provide insights into the validity of using convenient samples in surgical education research.
Participants: Thirteen medical students and thirteen college students without prior experience in laparoscopy participated in the study. The study protocols for medical and college students were approved by the Carilion Clinic IRB (Carilion 19-423/VT 19-51) and VT IRB (VT 23-565), respectively.
Apparatus: A FLS trainer box with equipment for the peg transfer task was placed on a height-adjustable desk. The equipment included two Maryland graspers, a pegboard, and six rubber objects. A 19-inch height-adjustable monitor displayed the pegboard inside the trainer box.
Tasks: Participants in both groups practiced the FLS peg transfer task during multiple one-hour sessions. Each session consisted of cycles of 10 minutes of practice followed by a 2-minute break. Medical students attended two practice sessions for the peg transfer task, and college students practiced the same task until they reached either the proficiency criteria defined by the FLS program or a maximum of six practice sessions. For comparison, only the first two sessions were analyzed.
Results: After data filtering, nine medical students and thirteen college students were included in the data analysis. Following the criteria of prior studies, data were excluded based on task errors (e.g., dropping objects), measurement issues (e.g., equipment malfunction), excessively long elapsed times (e.g. trials exceeding 5 minutes) or insufficient trials in a session, and insufficient eye-tracking data. Different filtering criteria were applied to each group based on the specific protocols of their respective studies. All data in the analysis were collected from right-handed participants .
Task completion times from the first and last trials of the first and the second sessions within same group were analyzed with repeated measures ANOVA, and the times between groups at same time points were analyzed with one-way ANOVA. Medical students had significantly shorter task completion times than non-medical students on the first trial of the first session. For medical students, task completion of the first trial of the first session showed significant difference to all subsequent trials including the last trial of the first session and the first and the last trials of the second session. Medical students did not exhibit any significant differences in task completion times between the last trial of the first session and the first trial of the second session, as well as the last trial of the second session. For college students, the time difference between the last trial of the first session and the first trial of the second session was not significant; however, both times were significantly shorter than the time on the first trial of the first session and significantly longer than the time on the last trial of the second session. No significant differences were found between the groups on the last trial of the second session.
Discussion: Medical students showed better initial performance than college students, suggesting that prior medical knowledge, exposure to surgical concepts, and potentially higher motivation driven by their choice in their profession could be beneficial. That is, potential selection bias might have contributed to the initial performance differences between the groups. However, medical students may experience a performance plateau earlier, as no significant improvements were observed after the last trial of the first session.. In contrast, college students showed incremental improvements throughout the second session, eventually reaching performance levels comparable to medical students by the end of the second session.
Limitations of this study include that the analysis only included the first two sessions, which does not account for the total time required to reach proficiency. Additionally, this analysis only examined task completion time. Collecting and analyzing other types of data, such as gaze and motion data, would improve our understanding on the difference between groups. Lastly, this study relied on limited numbers of participants in each group.
Akand, M., Altintas, E., Kilic, O., Gul, M., & Erdogdu, M. B. (2016). Does previous video game experience affect laparoscopic skills? Evaluation of non-medical school students with a novel laparoscopic training box. Int J Clin Exp Med, 9(6), 10757-10765.
Ali, M. R., Mowery, Y., Kaplan, B., & DeMaria, E. J. (2002). Training the novice in laparoscopy. Surgical Endoscopy and Other Interventional Techniques, 16, 1732-1736.
Furer, S., Alam, S., & Rosser, J. (2017). Performance of High School Students in a Laparoscopic Training Program. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 21(2), e2016.00059.
This research was supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR003015, and the Smart and Connected Health of the National Science Foundation under Award Number #2406439.
Substantial research has been devoted to accelerating skill acquisition from medical training, often based on convenient samples as opposed to medical professionals or trainees (Akand et al., 2016; Ali et al., 2002; Furer et al., 2016). This article compares motor skill development between medical students and non-medical college students practicing the FLS peg transfer task under near-identical experimental setups and procedures across two experiments. The goal is to examine whether skill development patterns differ between the two groups, thereby providing empirical evidence on what data collected from non-medical students can be generalized to medical students in the context of laparoscopic surgery training. These findings will provide insights into the validity of using convenient samples in surgical education research.
Participants: Thirteen medical students and thirteen college students without prior experience in laparoscopy participated in the study. The study protocols for medical and college students were approved by the Carilion Clinic IRB (Carilion 19-423/VT 19-51) and VT IRB (VT 23-565), respectively.
Apparatus: A FLS trainer box with equipment for the peg transfer task was placed on a height-adjustable desk. The equipment included two Maryland graspers, a pegboard, and six rubber objects. A 19-inch height-adjustable monitor displayed the pegboard inside the trainer box.
Tasks: Participants in both groups practiced the FLS peg transfer task during multiple one-hour sessions. Each session consisted of cycles of 10 minutes of practice followed by a 2-minute break. Medical students attended two practice sessions for the peg transfer task, and college students practiced the same task until they reached either the proficiency criteria defined by the FLS program or a maximum of six practice sessions. For comparison, only the first two sessions were analyzed.
Results: After data filtering, nine medical students and thirteen college students were included in the data analysis. Following the criteria of prior studies, data were excluded based on task errors (e.g., dropping objects), measurement issues (e.g., equipment malfunction), excessively long elapsed times (e.g. trials exceeding 5 minutes) or insufficient trials in a session, and insufficient eye-tracking data. Different filtering criteria were applied to each group based on the specific protocols of their respective studies. All data in the analysis were collected from right-handed participants .
Task completion times from the first and last trials of the first and the second sessions within same group were analyzed with repeated measures ANOVA, and the times between groups at same time points were analyzed with one-way ANOVA. Medical students had significantly shorter task completion times than non-medical students on the first trial of the first session. For medical students, task completion of the first trial of the first session showed significant difference to all subsequent trials including the last trial of the first session and the first and the last trials of the second session. Medical students did not exhibit any significant differences in task completion times between the last trial of the first session and the first trial of the second session, as well as the last trial of the second session. For college students, the time difference between the last trial of the first session and the first trial of the second session was not significant; however, both times were significantly shorter than the time on the first trial of the first session and significantly longer than the time on the last trial of the second session. No significant differences were found between the groups on the last trial of the second session.
Discussion: Medical students showed better initial performance than college students, suggesting that prior medical knowledge, exposure to surgical concepts, and potentially higher motivation driven by their choice in their profession could be beneficial. That is, potential selection bias might have contributed to the initial performance differences between the groups. However, medical students may experience a performance plateau earlier, as no significant improvements were observed after the last trial of the first session.. In contrast, college students showed incremental improvements throughout the second session, eventually reaching performance levels comparable to medical students by the end of the second session.
Limitations of this study include that the analysis only included the first two sessions, which does not account for the total time required to reach proficiency. Additionally, this analysis only examined task completion time. Collecting and analyzing other types of data, such as gaze and motion data, would improve our understanding on the difference between groups. Lastly, this study relied on limited numbers of participants in each group.
Akand, M., Altintas, E., Kilic, O., Gul, M., & Erdogdu, M. B. (2016). Does previous video game experience affect laparoscopic skills? Evaluation of non-medical school students with a novel laparoscopic training box. Int J Clin Exp Med, 9(6), 10757-10765.
Ali, M. R., Mowery, Y., Kaplan, B., & DeMaria, E. J. (2002). Training the novice in laparoscopy. Surgical Endoscopy and Other Interventional Techniques, 16, 1732-1736.
Furer, S., Alam, S., & Rosser, J. (2017). Performance of High School Students in a Laparoscopic Training Program. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 21(2), e2016.00059.
This research was supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR003015, and the Smart and Connected Health of the National Science Foundation under Award Number #2406439.
Event Type
Oral Presentations
TimeWednesday, April 29:00am - 9:30am EDT
LocationPier 9
Simulation and Education (SE)