Background: Simulation can provide an adjunctive means of surgical training for Gynaecology trainees, yet there are barriers to this type of training such as time and equipment access.
Aim: To evaluate the impact of a simulation-training program utilising take-home box trainers on the laparoscopic skills of trainees.
Methods: A cohort study was undertaken at a tertiary hospital in Brisbane. Participants (N=17 in 2015, N=16 in 2016) were supplied with a box trainer, associated equipment and instructions on self-directed training. Half of the participants were randomly allocated a mentor. Assessment of laparoscopic skills was performed in box trainer and virtual reality simulator tasks pre- and post-training. Participants were supplied with logbooks and practice time was reviewed, including analysis by mentor allocation.
Results: In 2015, trainees demonstrated an improvement in the median time to complete a virtual reality laparoscopic tubal ligation task (baseline 124 seconds versus post-training 91 seconds, P=0.041). There was no difference in the number of tubal ligation bleeding incidents, or in the time taken to complete the box trainer task. In 2016, trainees demonstrated improvement in tubal ligation time (251 versus 71 seconds, P=0.021) and virtual reality bilateral oophorectomy time (891 seconds versus 504, P=0.025). When combining all data from the 2015 and 2016 groups, significant improvements were observed in both the time and number of bleeding incidents in the tubal ligation task. There was no significant difference in other outcome measures or when groups were compared by mentor allocation. Some trainees failed to complete logbooks or all assessment tasks.
Conclusion: In two years of a take-home box trainer simulation-training program, improvements were observed in laparoscopic skills. A lack of logbook completion and compliance with assessment tasks may indicate suboptimal program engagement; a notable occurrence given the program was designed to overcome barriers to training. Further research may help to refine the essential components of curriculum design and enhance trainee engagement. This type of program may improve trainee access to simulation training.