Laparoscopic skills training using inexpensive box trainers: which exercises to choose when constructing a validated training course

Please cite this paper as: Schreuder H, van den Berg C, Hazebroek E, Verheijen R, Schijven M. Laparoscopic skills training using inexpensive box trainers: which exercises to choose when constructing a validated training course. BJOG 2011;118:1576–1584. Objective To obtain face and construct validity for a new training course to be used in any type of box/video trainer and to give a comprehensive overview of validated exercises for box/video training. Design Cross‐sectional study. Setting University Medical Centre. Population Students, residents and consultants. Methods Participants (n = 42) were divided into three groups according to their laparoscopic experience: ‘Novices’ (n = 18), ‘Intermediates’ (n = 14) and ‘Experts’ (n = 10). A laparoscopic training course consisting of six exercises was constructed. To emphasise precision, a penalty score was added. Every participant performed two repetitions of the exercises; total score per exercise was calculated. To determine face validity, participants filled in a questionnaire after completion of the exercises. An evidence‐based literature search for validated box/video trainer exercises was performed. Main outcome measures Face and construct validity. Results The mean score of the ‘experts’ was set as the training target. Total scores appeared to be positively correlated with individual’s laparoscopic experience. The overall score and the score for each exercise were significantly higher in the intermediate and expert groups when compared with the novice group (P ≤ 0.001). All participants completed the questionnaire. The overall assessment of the exercises was considered to be good. The course was found to be most appropriate for training residents year 1–3. Conclusion Face and construct validity for an inexpensive course for box/video training was established. A comprehensive and practical overview of all validated and published exercises for box/video trainers is provided to facilitate an inexpensive, but optimal and tailored selection for training purposes.