Home-based self-regulated training vs. centralised instructor-regulated training in laparoscopy: A randomised comparative trial

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Background: Simulation-based surgical training improves trainees’ operative skills without jeopardising patient safety. Proficiency-based training (PBT) is a mastery learning approach to skills training. The goal is to bring trainees to the same performance level while accommodating the ability of the individual. Studies of PBT in laparoscopy have shown promising results. However, PBT can be more time consuming than traditional interval training. Furthermore, studies on the role of instructor feedback in surgical training have produced varying results with some studies even pointing towards negative outcomes of feedback. In line with these findings, recent studies have successfully applied theories of self-regulated learning (SRL) to simulation-based training. Summary of Work: Based on experiences of PBT, SRL and the ambiguous role of the instructor, we have conducted a randomised study comparing home-based self-regulated training (HSRT) to centralised instructor-regulated training (CIRT) in basic laparoscopic skills. We included 46 first-year trainees in Surgery, Gynaecology and Urology. Trainees were randomly allocated to HSRT or CIRT. During the 6-week training program, the HSRT group trained at home guided by video tutorials and written instructions, while the CIRT group attended two training sessions instructed by surgical experts. Training in both groups was structured as PBT with validated tasks and protected training time. All participants trained on portable box trainers providing computerised summary feedback on metrics. Pre- and post tests consisted of validated exercises in camera navigation, hand-eye and bi-manual coordination. Summary of Results: Our preliminary analyses (n = 40) show an overall pass rate of 90% (95% HSRT, 86% CIRT). All trainees significantly improved in hand-eye and bi-manual coordination. Home-based training facilitated distributed practice. The preliminary findings reveal no significant inter-group differences in performance and training time. Discussion and Conclusions: To our knowledge this is the first study to successfully apply evidence-based supports for SRL to home-based training in basic laparoscopic skills. At AMEE 2020, we will share the final results on performance and training patterns. We argue that home-based training in laparoscopy is feasible and effective given a well-designed training program with supports for SRL. Take-home Messages: Home-based self-regulated training allows for time-consuming PBT, facilitates distributed practice, saves time and money, and reserves the use of supervisors for more advanced training.
Original languageEnglish
Publication yearSep 2020
Publication statusPublished - Sep 2020
EventAMEE 2020: The Virtual Conference -
Duration: 7 Sep 20209 Sep 2020


ConferenceAMEE 2020
Internet address

See relations at Aarhus University Citationformats


  • AMEE 2020

    Activity: Participating in or organising an event typesParticipation in or organisation af a conference

ID: 196178885