Didactic lectures versus simulation training: a randomised pilot evaluation of its impact on surgical skill

Abstract

Background: The Bristol enquiry and national surveys have highlighted medicolegal concerns, reduction in training time available for trainees and the change from trainees performing procedures for the first time on patients. The Royal Colleges have taken an active role in advocating the use of simulation training prior to doctors undertaking operative procedures in real time. This study compares didactic lecture-based teaching to simulation training using a quantitative assessment tool. Method: Randomised pilot study including 20 trainees within their first and second year of Obstetrics and Gynaecology training. The participants were randomised to one of two groups. Group A were taken through the 10 steps to perform a diagnostic laparoscopy with a lecture, followed by an assessment using a laparoscopic pelvic box trainer. Group B were given the same didactic lecture, followed by simulation training in a dry lab, prior to undergoing the same assessment as group A. Findings: The study demonstrates a statistically significant improvement in the overall OSATS score for trainees undertaking a hands-on simulation training session prior to completing the diagnostic laparoscopy assessment (p = 0.023). Conclusions: This study clearly demonstrates that exposure to simulation training is superior compared to didactic lecture-based teaching for the acquisition of surgical skills.