Clinical Scorecard: A Randomized Controlled Trial Comparing Home and Hospital-Based Training Using the Portable Laparoscopic Endo-Trainer (PLET)

At a Glance

Key Highlights

• Laparoscopic procedures are the gold standard for most abdominal surgeries requiring proficient laparoscopic skills.
• Training opportunities during clinical hours are limited due to workload, working hour restrictions, and pandemic-related reductions in elective surgeries.
• The portable laparoscopic endo-trainer (PLET) enables flexible, high-quality laparoscopic skill training at home or hospital with similar performance outcomes.

Guideline-Based Recommendations

Diagnosis

• Use Objective Structured Assessment of Technical Skills (OSATS) to evaluate laparoscopic skill performance.

Management

• Implement structured laparoscopic training using portable trainers like PLET either at home or in hospital settings.
• Provide instructional videos and expert support to facilitate independent skill acquisition.

Monitoring & Follow-up

• Assess skill improvement longitudinally over a 12-week training period using validated tools such as OSATS.
• Collect qualitative feedback to understand trainee motivation and challenges.

Risks

• Limited training opportunities may compromise surgical skill acquisition and patient safety.
• Reduced elective surgeries and shorter hospital stays may decrease hands-on training exposure.

Patient & Prescribing Data

Surgical residents undergoing laparoscopic skill training

Home-based training with PLET is feasible and yields comparable skill improvement to hospital-based training, supporting flexible learning environments.

Clinical Best Practices

• Incorporate portable laparoscopic trainers into residency curricula to supplement limited OR training time.
• Use Peyton’s 4-step method and instructional videos to enhance skill acquisition.
• Provide continuous expert support remotely or in person to address trainee questions.
• Encourage regular practice sessions over several weeks to consolidate laparoscopic skills.
• Adapt training modalities to accommodate pandemic-related restrictions and workload challenges.

References

• Laparoscopic procedures as gold standard
• Peyton’s 4-step method for surgical training
• Objective Structured Assessment of Technical Skills (OSATS)
• Impact of COVID-19 on surgical training
• Portable laparoscopic endo-trainer (PLET) study protocol