Laparoscopic Skill Improvement After Virtual Reality Simulator Training In Medical Students As Assessed By Augmented Reality Simulator

Introduction: Definitive assessment of laparoscopic skill improvement after virtual reality simulator training is best obtained during an actual operation. However, this is impossible in medical students. Therefore, we developed an alternative assessment technique using an augmented reality simulator.Methods: Nineteen medical students completed a 6-week training program using a virtual reality simulator (LapSim). The pretest and post-test were performed using an object-positioning module and cholecystectomy on an augmented reality simulator(ProMIS). The mean performance measures between pre-and post-training on the LapSim were compared with a paired t-test.Results: In the object-positioning module, the execution time of the task (P < 0.001), left and right instrument path length (P = 0.001), and left and right instrument economy of movement (P < 0.001) were significantly shorter after than before the LapSim training. With respect to improvement in laparoscopic cholecystectomy using a gallbladder model, the execution time to identify, clip, and cut the cystic duct and cystic artery as well as the execution time to dissect the gallbladder away from the liver bed were both significantly shorter after than before the LapSim training (P = 0.01).Conclusions: Our training curriculum using a virtual reality simulator improved the operative skills of medical students as objectively evaluated by assessment using an augmented reality simulator instead of an actual operation. We hope that these findings help to establish an effective training program for medical students.