Title: Determining the optimal frequency of skill labs for training and skill retention on endoscopic suturing
Authors: De Win, G.
Van Cleynenbreugel, Ben
De Ridder, Dirk
Miserez, Marc #
Issue Date: Apr-2006
Publisher: Elsevier Science
Host Document: European urology supplements vol:5 issue:2 pages:60
Conference: EAU date:2006
Abstract: INTRODUCTION & OBJECTIVES: This study was undertaken to determine the optimal distribution of
training sessions to teach intracorporal endoscopic suturing with good retention of skills, in medical students.
MATERIAL & METHODS: A total of 145 novice subjects (medical students between age of 18 and 23)
were recruited for this study. After baseline tests for spatial ability, motivation and ambidexterity, to ascertain
comparability between the groups, the students were categorized and randomised into six groups to receive
6 training sessions of 1.5 h in laparoscopic intracorporal suturing. Group A received 3 training sessions
per day with a rest period of 20 minutes in between during 2 consecutive days, Group B 2 sessions per day
(same rest period) during 3 consecutive days, Group C 1 session per day during 6 consecutive days, Group
D 1 training each 2 days, Group E 1 training session a week, and group F 1 training session a week with a
possibility for “self-training” in between. The exercises performed in each group were similar. Each student
did get the same standard feedback at the same time. After the fi nal training session, all groups had a 30-min
rest period, followed by an evaluation test (posttest). A 5 cm chicken skin incision had to be closed with 3
knots, using the learned suturing technique. 1 month after completing the training, the evaluation test was
repeated for measuring 1 month skill retention. Cumulative time to adapt the skin edges adequately was used
as endpoint for qualitative and quantitative analysis. The mean time (and SEM) for performance in each group
was calculated. One-Way ANOVA analysis of variance (P<0.05) was used to assess statistical signifi cance
on the evaluation test and retention test separately. A Tukey’s Multiple Comparison Test was used to fi nd
differences between the 6 groups.
All groups were similar at the start. On the evaluation test; P value was 0.0030. The Tukey test revealed a
statistical difference between group A and C, group B and C, group C and E and group C and F; as shown
in the graph. On the 1 month retention test P value was 0.0036. Although group C remained graphically the
best, the Tukey test revealed now a statistical difference between group A and all the other groups (except
group E).
CONCLUSIONS: Immediately after training, one training session of 1.5h a day seems the most benefi cial
for learning intracorporal endoscopic suturing. After 1 month, distributed shorter training still remains better than massed practice.
ISSN: 1569-9056
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Urology Section (-)
Abdominal Surgical Oncology
# (joint) last author

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