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Bellows et al. Laparoscopic training for surgical residents

evaluating if home training is viable, however it was of laparoscopic surgery skills training results in durable performance
not performed to determine if programs can “avoid improvement and a uniform certification pass rate. Surg Endosc
obligations” and “negate” work hours regulations. Our 2010;24:2453-7.
study found that novice individuals trained on either 4. Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ,
Euhus DM, Jeyarajah DR, Thompson WM, Jones DB. Laparoscopic
the home or the on-site training device were able training on bench models: better and more cost effective than operating
to improve their laparoscopic skills objectively and room experience? J Am Coll Surg 2000;191:272-83.
subjectively using an independent proficiency-based 5. Gonzalez R, Bowers SP, Smith CD, Ramshaw BJ. Does setting
training method. However, none of the participants specific goals and providing feedback during training result in better
practiced for more than 1 or 2 h in the 3-month acquisition of laparoscopic skills? Am Surg 2004;70:35-9.
training period. Therefore, we feel that the only valid 6. Snyder CW, Vandromme MJ, Tyra SL, Hawn MT. Proficiency-based
conclusion that can be drawn is that when overworked laparoscopic and endoscopic training with virtual reality simulators:
a comparison of proctored and independent approaches. J Surg Educ
and exhausted trainees who are expected to train on 2009;66:201-7.
their own time, do not regularly engage in training 7. Curet MJ. Resident work hour restrictions: where are we now? J Am
exercises, regardless of whether these are provided at Coll Surg 2008;207:767-76.
home or in the workplace. The solution to conducting 8. Damadi A, Davis AT, Saxe A, Apelgren K. ACGME duty-hour
training in a stressful work environment may not be restrictions decrease resident operative volume: a 5-year comparison
to simply “suggest” that trainees practice at home, at an ACGME-accredited university general surgery residency. J Surg
but rather to understand the work-related stressors Educ 2007;64:256-9.
and reconfigure jobs, and perhaps even to increase 9. Pape HC, Pfeifer R. Restricted duty hours for surgeons and impact
on residents quality of life, education, and patient care: a literature
staffing, to minimize stress exposure. review. Patient Saf Surg 2009;3:3.
10. Chang L, Petros J, Hess DT, Rotondi C, Babineau TJ. Integrating
DECLARATIONS simulation into a surgical residency program: is voluntary participation
effective? Surg Endosc 2007;21:418-21.
Authors’ contributions 11. Brydges R, Carnahan H, Safir O, Dubrowski A. How effective is self-
Study design and manuscript preparation: C.F. Bellows guided learning of clinical technical skills? It’s all about process. Med
Manuscript preparation and data analysis: A.A. Smith Educ 2009;43:507-15.
12. Wulf G, Raupach M, Pfeiffer F. Self-controlled observational practice
enhances learning. Res Q Exerc Sport 2005;76:107-11.
Acknowledgments 13. Safir O, Dubrowski A, Hui Y, Backstein D, Carnahan H. Self-directed
The authors thank Cheri Touchard and Steven Au for practice scheduling is equivalent to instructor guided practice when
their help with the conduct of this study. learning a complex surgical skill. Procedia Social Behavioral Sci
2010;2:792-6.
Financial support and sponsorship 14. Leff DR, Aggarwal R, Rana M, Nakhjavani B, Purkayastha S, Khullar
None. V, Darzi AW. Laparoscopic skills suffer on the first shift of sequential
night shifts: program directors beware and residents prepare. Ann Surg
Conflicts of interest 2008;247:530-9.
There are no conflicts of interest. 15. Fundamentals of Laparoscopic Surgery. Available from: https://www.
flsprogram.org/. [Last accessed on August 16, 2017]
16. Korndorffer JR Jr, Dunne JB, Sierra R, Stefanidis D, Touchard
Patient consent CL, Scott DJ. Simulator training for laparoscopic suturing using
All study subjects provided appropriate consent as performance goals translates to the operating room. J Am Coll Surg
per the Institutional review board protocol prior to 2005;201:23-9.
participating in the study. 17. Ritter EM, Scott DJ. Design of a proficiency-based skills training
curriculum for the fundamentals of laparoscopic surgery. Surg Innov
Ethics approval 2007;14:107-12.
Institutional review board approval was obtained prior 18. Chung SY, Landsittel D, Chon CH, Ng CS, Fuchs GJ. Laparoscopic
skills training using a webcam trainer. J Urol 2005;173:180-3.
to initiation of the study. 19. Sharpe BA, MacHaidze Z, Ogan K. Randomized comparison of
standard laparoscopic trainer to novel, at-home, low-cost, camera-less
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