Randomly Alternating Image Presentation During Laparoscopic Training Leads to Faster Automation to the “Fulcrum Effect”

Abstract
Background and Study Aims: The aim of this study was to evaluate four training programmes intended to help laparoscopic surgeons automate to the “fulcrum effect”. Methods: A total of 32 participants (16 men, 16 women), were randomly assigned to one of four different image-viewing conditions: full binocular, y-axis inverted, normal laparoscopic and randomly alternating (between y-axis-inverted and normal laparoscopic). The subjects were requested to perform 10 trials of a simple laparoscopic cutting task, each lasting 2 minutes. Each then completed a 2-minute test under normal laparoscopic imaging conditions. Results: In the final test trial, participants who trained under the randomly alternating imaging conditions (y-axis inverted and normal laparoscopic) performed significantly better than those from the other groups. Conclusion: Training under a randomly alternating viewing condition helps laparoscopic trainees automate to the “fulcrum effect” faster.

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