Performance Variables and Professional Experience in Simulated Laparoscopy: A Two-Group Learning Curve Study

Jan-Maarten Luursema*, Maroeska M. Rovers, Marleen Groenier, Harry van Goor

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)
2 Downloads (Pure)


Objective: Virtual reality simulators are increasingly used in laparoscopy training. Such simulators allow objective assessment of performance. However, both low-level variables and overall scores generated by the simulator can be hard to interpret. We present a method to generate intermediate performance variables and show how the resulting variables can be used to investigate the development of laparoscopic skills.

Design: A beginner group (n = 16) and a group with intermediate laparoscopic experience (n = 9) participated in a 5-session, basic skills training course hosted by the Department of Technical Medicine at the University of Twente. Multiple simulator-generated variables were aggregated into 4 performance variables: duration, left-hand motion, right-hand motion, and damage. Differences in performance were analyzed in relation to proficiency values.

Results: Damage performance differentiated the most between groups and proficiency values; motion performance variables differentiated the least. The more experienced group outperformed the beginner group at damage by the end of the course.

Conclusions: Differentiating between duration, left-hand motion, right-hand motion, and damage is a useful way to investigate laparoscopic performance development. Different performance variables follow different trajectories toward expertise. Valid and reliable clinical damage parameters are needed to investigate the relation of real-world damage to simulator damage.
Original languageEnglish
Pages (from-to)568-573
JournalJournal of surgical education
Issue number4
Publication statusPublished - 2014


  • 2023 OA procedure


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