Comparative study to determine the proper sequence of simulation training: Pelvic Trainer versus Virtual Reality Simulator

Abstract

Abstract Background: Since its inception, the adoption of minimally invasive surgical techniques has increased dramatically due to improved patient outcomes. Over the last decade, simulation-based surgical education has received significant attention. Several laparoscopic simulators have been employed. Box trainers (BTs) or pelvic trainers and virtual reality (VR) simulators are the two main training modalities employed in hospitals and clinical training centers for laparoscopic skills acquisition and development. The aim of our study was to evaluate the proper sequence of pelvic trainers and VR simulator training to improve gynecological laparoscopic skills. Methodology: This quasi-experimental counterbalanced design study was conducted among twenty residents with little or no laparoscopic experience at the Virtual Endoscopic Simulation and Skills Acquisition Lab at Kasr Al Ainy Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Egypt, from February 2022 to August 2022. The participants were subdivided into two equal groups. Group A began their training with a pelvic trainer and was assessed using a checklist; then they were trained on a VR simulator and were assessed using electronic auto assessment via the simulator. Group B began their training on a VR simulator and was assessed using electronic auto assessment via the simulator; then they were trained on pelvic trainers and were assessed using a checklist. Results: When comparing the results of the assessment of pelvic trainer skills between the two trained groups, there was no significant difference in camera navigation, cutting pattern, peg transfer, or running stitches (P values 0.646, 0.341, 0.179, and 0.939 respectively), and when comparing the results of the assessment of VR simulator skills between the 2 trained groups, there was no significant difference in camera navigation, cutting pattern, peg transfer, or running stitches (P values 0.79, 0.3, 0.33, and 0.06, respectively). Conclusion: There was no difference in training, whether started on a pelvic trainer or the VR simulator, so both could be used in laparoscopic training with no preferred order. Trial registration: The trial is registered at clinicaltrials.gov with the name " Pelvic trainer vs VRS" and the identifier " NCT05255614" The date of registration was January 19, 2022, and the trial was prospectively registered. URL: https://register.clinicaltrials.gov/prs/app/action/ViewOrUnrelease?uid=U0004GED&ts=22&sid=S000BR5D&cx=t6mc14