Training simulator efficacy in developing thoracic and general surgical skills in a residency program: a pilot study

Objectives: Virtual training simulators have been introduced in several surgical disciplines to improve residents' abilities. Through the use of the LapSim® virtual training simulator (Surgical Science, Göteborg, Sweden), this study aims to plan an effective learning path in minimally invasive thoracic and general surgery.
Methods: All thoracic and general surgery trainees in their first and second year of residency at the University of Insubria were enrolled and randomized into two groups: residents undergoing an intensive twice-a-week virtual training program (Group A: n = 8) and those undergoing a once-weekly non-intensive virtual training program (Group B: n = 9). The virtual training program was divided into four modules, each of 12 weeks. In the first module, trainees repeated grasping, cutting, clip application, lifting and grasping, and fine dissection exercises during each training session. Seal-and-cut exercise was performed as the initial and final test. Data on surgical manoeuvres (time and on mistakes) were collected; intra- and inter-group comparisons were planned.
Results: No significant differences were observed between Groups A and B at the first session, confirming that the two groups had similar skills at the beginning. After 12 weeks both groups showed improvements, but comparing data between initial and final test, only Group A registered a significant reduction in total time (p-value =0.0015), left (p-value =0.0017) and right (p-value =0.0186) instrument path lengths, and in left (p-value = 0.0010) and right (p-value =0.0073) instrument angular path lengths, demonstrating that Group A acquired greater precision in surgical manoeuvres.
Conclusions: Virtual simulator training program performed at least twice-a-week was effective for implementing basic surgical skills required for the trainee's professional growth. Additional virtual training modules focused on more complex exercises are planned to confirm these preliminary results.