Virtual reality training improves simulated laparoscopic surgery performance in laparoscopy naïve medical students

Purpose: With the expanding role of laparoscopy in urologic practice, efficient and safe training has become paramount. Virtual reality simulation may potentially aid training, but it requires validation before it can be incorporated into training programs. The objective of this study was to assess whether training on a virtual reality (VR) laparoscopy simulator (LAP Mentor™) can improve performance of virtual laparoscopic procedures. Materials and Methods: After a basic introduction to the LAP Mentor, 32 inexperienced medical students performed a baseline VR cholecystectomy that was observed and scored by two observers using the Objective Structured Assessment of Technical Skills (OSATS). The students were then randomized to two groups: Group 1 trained on the simulator without supervision during a total of six 30-minute sessions, and group 2 received no training. Students were then reevaluated on a second VR cholecystectomy by the same observers. Results: All 32 students completed the study. The two groups were comparable with regard to baseline OSATS scores (group 1, 16.6 ± 4.3 v group 2, 15.67 ± 6.3, P = 0.2). On the second evaluation, the trained students (group 1) performed significantly better than the control group (group 2) (27.9 ± 7.2 v 17.6 ± 6.2, P < 0.001). Group 1 students outperformed group 2 students in each category of the OSATS. Moreover, trained students improved their scores by at least 20% (P < 0.001) in each category, while the untrained students improved only in the "knowledge of procedure" category by 25% (P = 0.03). Conclusion: Skills training on a LAP Mentor VR simulator improved VR surgical performance. Before incorporating this simulator into resident education, the LAP Mentor will have to undergo testing for predictive and construct validity.