Establishing a curriculum for the acquisition of laparoscopic psychomotor skills in the virtual reality environment

BACKGROUND: The unique psychomotor skills required in laparoscopy result in reduced patient safety during the early part of the learning curve. Evidence suggests that these may be safely acquired in the virtual reality (VR) environment. Several VR simulators are available, each preloaded with several psychomotor skills tasks that provide users with computer-generated performance metrics. This review aimed to evaluate the usefulness of specific psychomotor skills tasks and metrics, and how trainers might build an effective training curriculum. METHODS: We performed a comprehensive literature search. RESULTS: The vast majority of VR psychomotor skills tasks show construct validity for one or more metrics. These are commonly for time and motion parameters. Regarding training schedules, distributed practice is preferred over massed practice. However, a degree of supervision may be needed to counter the limitations of VR training. CONCLUSIONS: In the future, standardized proficiency scores should facilitate local institutions in establishing VR laparoscopic psychomotor skills curricula. (C) 2012 Elsevier Inc. All rights reserved.