# Optimizing skill acquisition: the role of self-assessment during a continuous training program for laparoscopic suturing

## TL;DR

This study explores how self-assessment before practice affects learning laparoscopic suturing, finding that lower frequency still offers benefits.

## Contribution

The study identifies optimal self-assessment frequency for laparoscopic suturing training efficiency.

## Key findings

- No significant differences in primary outcomes like time and distance between groups.
- Self-assessment groups showed improvements in secondary outcomes like smoothness and speed.
- Lower frequency of self-assessment still provided comparable benefits, optimizing training.

## Abstract

Mastering laparoscopic suturing, a critical aspect of minimally invasive surgery, remains a challenge. Self-assessment and ‘reflection before practice’ may enhance the learning curve of laparoscopic suturing. This study investigates the optimal frequency of self-assessment and reflection before practice in laparoscopic suturing training.

Participants (medical students, surgical residents, and medical PhD students) underwent laparoscopic suturing training at home using a laparoscopic simulator (LaparoscopyBoxx). Three groups were formed: a ‘control group’ without self-assessment, a ‘periodic self-assessment group’, and a ‘continuous self-assessment group’. The validated Laparoscopic Suturing Competency Assessment Tool (LS-CAT) served as self-assessment form. Participant’s performance was quantified by objective parameters (time, distance, handedness, off-screen time, speed, acceleration, smoothness and distance between the instruments) measured by SurgTrac software.

No significant differences were observed between groups for primary outcome parameters time and distance across tests. However, significant differences emerged in secondary outcome parameters off-screen (baseline-test, p = 0.018), acceleration (baseline-test, p = 0.007), smoothness (baseline-test, p = 0.004; after-test, p = 0.038) and speed (after-test, p = 0.033) at various tests, favoring the self-assessment groups.

Self-assessment and reflection before practice may lead to more efficient instrument utilization and increased safety. A lower frequency of self-assessment and reflection before practice offered comparable benefits, which optimizes training efficiency, and is therefore recommended.