Randomized controlled trial on the effect of coaching in simulated laparoscopic training

Seventeen surgically naive medical students were randomized into two groups: eight were placed into an intervention group and received structured coaching, and nine were placed into a control group and received no training. They each performed 10 laparoscopic cholecystectomies on a virtual reality simulator. The surgical quality of the first, fifth, and 10th operations was evaluated by 2 independent blinded assessors using the Competency Assessment Tool (CAT) for cholecystectomy. Understanding of operative strategy was tested before the first, fifth, and 10th operation. Performance metrics, path length, total number of movements, operating time, and error frequency were evaluated. The groups were compared by the Mann–Whitney U test. Proficiency gain curves were plotted using curve fit and CUSUM models; change point analysis was performed by multiple Wilcoxon signed rank analyses.