Background: Surgical training has traditionally involved teaching trainees in the operating theatre. However, this method is associated with longer operating times and complications, which is cost-inefficient and exposes patients to errors. Simulation modalities such as Touch Surgery, which utilises cognitive task analysis (CTA), have been designed to overcome these issues.

Methods: Participants performed a laparoscopic cholecystectomy procedure using a box simulator and porcine liver and gall bladder. They were randomly allocated to either the control or the intervention group. Each group received the same preparation prior to intervention, including a 10-minute introduction to laparoscopic equipment and a 15-minute educational tutorial on laparoscopic cholecystectomies. The participants then received CTA training via either Touch Surgery (intervention) or via written information (control).

Results: 40 participants were recruited to take part in the study and randomly assigned to either intervention (n=22) or control (n=18). There was no significant difference between age (p=0.320), year of medical school (p=0.322), handedness (p=1.000) or gender (p=0.360) of the groups. The overall mean performance score was higher for intervention (41.9±22.5) than control (24.7±19.6; p=0.016). The intervention group had consistently higher scores throughout all intraoperative segments although this was not statistically significant (p>0.050).

Conclusion: This study shows that Touch Surgery is effective for providing cognitive training in laparoscopic cholecystectomies to medical students. It is likely that this effect will be seen across modules and other platforms that utilise CTA alongside high fidelity animation. Further work is necessary to extend this to other surgical procedures for evaluating its longitudinal effectiveness.

Take Home Message: CTA training provided via high fidelity simulation is an effective and inexpensive method of providing surgical education.