• Joe Uccelli, Kanav Kahol, Aaron Ashby, Marshall Smith, and John Ferrara.
• Phoenix Integrated Surgical Residency, Phoenix, AZ, USA.
• Am. J. Surg. 2011 Mar 1; 201 (3): 315-9; discussion 319.

BackgroundIt is unknown whether surgical residents who learn minimal-access surgery skills in an unstructured environment (ie, at home), will develop a technical skill set that rivals that of those trained in the more traditional, structured learning environment.MethodsSeven surgery residents were provided structured learning through didactic and hands-on skills training sessions and consistent supervision throughout training. A second group of 7 residents participated in an unstructured learning curriculum of training without supervision. End points were determined at the end of training using a standardized simulator based on predetermined performance measures.ResultsBoth groups achieved high task scores, with comparable scores on gesture proficiency, hand movement smoothness, instrument movement smoothness, errors, and time elapsed. There was no significant difference between group differences in final skills scores.ConclusionsUnstructured learning is equally effective in delivering quality skills training when compared with structured training.Copyright © 2011 Elsevier Inc. All rights reserved.

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