• Liv Ahlborg, Leif Hedman, Henry Nisell, Li Felländer-Tsai, and Lars Enochsson.
• Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden; Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden; Department of Obstetrics and Gynecology, Södertälje Hospital, Södertälje, Sweden; Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.
• Acta Obstet Gynecol Scand. 2013 Oct 1; 92 (10): 1194-201.

ObjectiveTo investigate how simulator training and non-technical factors affect laparoscopic performance among residents in obstetrics and gynecology.DesignIn this prospective study, trainees were randomized into three groups. The first group was allocated to proficiency-based training in the LapSimGyn(®) virtual reality simulator. The second group received additional structured mentorship during subsequent laparoscopies. The third group served as control group. At baseline an operation was performed and visuospatial ability, flow and self-efficacy were assessed. All groups subsequently performed three tubal occlusions. Self-efficacy and flow were assessed before and/or after each operation.SettingSimulator training was conducted at the Center for Advanced Medical Simulation and Training, Karolinska University Hospital. Sterilizations were performed at each trainee's home clinic.PopulationTwenty-eight trainees/residents from 21 hospitals in Sweden were included.Methods/Main Outcome MeasuresVisuospatial ability was tested by the Mental Rotation Test-A. Flow and self-efficacy were assessed by validated scales and questionnaires. Laparoscopic performance was measured as the duration of surgery. Visuospatial ability, self-efficacy and flow were correlated to the laparoscopic performance using Spearman's correlations. Differences between groups were analyzed by the Mann-Whitney U-test.ResultsNo differences across groups were detected at baseline. Self-efficacy scores before and flow scores after the third operation were significantly higher in the trained groups. Duration of surgery was significantly shorter in the trained groups. Flow and self-efficacy correlate positively with laparoscopic performance.ConclusionsSimulator training and non-technical factors appear to improve the laparoscopic performance among trainees/residents in obstetrics and gynecology.© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

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