Incentivising practice with take-home laparoscopic simulators in two UK Core Surgical Training programmes

Laura G. Nicol*, Kenneth G. Walker, Jennifer Cleland, Roland Partridge, Susan J. Moug

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Introduction Practice using simulators has been validated as a mean for surgical trainees to improve basic laparoscopic skills and free their attention for higher cognitive functions. However, mere provision of equipment does not result in frequent practice. This study assesses one approach to incentivising practice within core surgical training programmes and leads to further recommendations. Methods 30 core surgical trainees (CST) starting laparoscopic-based specialties were recruited from East and West of Scotland CST programmes and given take-home laparoscopic simulators, with six training modules. Attainment of target metric scores generated an eCertificate, to be rewarded by progression in the live theatre. Questionnaires assessed confounding variables and explored CSTs' anxieties about laparoscopy. Results 27 trainees (90%) agreed to participate (mean age 28 years, range 24-25; 17 males). 13 CSTs (48%) were in the first year of surgical training. 11 (41%) had no previous simulation experience and 7 (32%) CSTs played video games >3 hours/week. 12 of 27 trainees (44%) completed ≥1 task and 7 completed all (26%). Performances improved in some participants, but overall engagement with the programme was poor. Reasons given included poor internet connectivity, busy rotations and examinations. CSTs who engaged in the study significantly reduced their anxiety (mean 4.96 vs 3.56, p<0.05). Conclusions The provision of take-home laparoscopic simulators with accompanying targets did not successfully incentivise CSTs to practise. However, the subgroup who did engage with the project reported performance improvements and significantly reduced anxiety. Proposals to overcome barriers to practising in simulation, including obligatory simulation-based assessments, are discussed.

Original languageEnglish
Pages (from-to)112-117
Number of pages6
JournalBMJ Simulation and Technology Enhanced Learning
Issue number4
Early online date16 Sept 2016
Publication statusPublished - 1 Nov 2016

Bibliographical note

Advice and single centre support was provided by Anna Paisley, Edinburgh Royal Infirmary, and Irfan Ahmed, Aberdeen Royal Infirmary. Programme support was provided by Andrew Renwick and Satheesh Yalamarthi, Programme Directors, West and East of Scotland Core Surgical Training Programmes.


  • Frequent Practice
  • Incentivised
  • Laparoscopic
  • Simulation
  • Surgery


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