Is Test-Enhanced Learning the Key to Improving Laparoscopic Box Trainer Simulation Training?

Introduction: Simulation is an effective training approach for laparoscopic surgery, but motivation and engagement of trainees to utilise laparoscopic trainers is variable. Test- enhanced learning (TEL) – using defined assessments throughout training – may offer at least part of the solution. The objective of this study was to as-sess the effects of TEL on a laparoscopic simulation program for medical students. Methods: A mixed methods cohort study was performed with a convenience sample of 40 medical students who were recruited to participate in a 10- week laparoscopic simulation program, using box trainers. Twenty students participated within a test- enhanced learning framework (‘TEL group’) and 20 students participated in the standard program (‘control group’). All students were invited to complete a survey relating to their experience in the training program. Results: Attendance in the TEL group was significantly higher than the control group 71% vs 51.5% p = 0.023. The TEL group also had faster mean time scores for all laparoscopic exercises performed at the end of the program, but the difference was not statistically significant. Four themes were identified from survey responses to influence engagement – 1) personal traits and motivation, 2) training context, 3) clear goals in the training process and 4) feedback enabling understanding of one’s own performance. Discussion: Testing of laparoscopic skills during the phase of learning in conjunction with individualised feedback and tracking of learning trajectory may increase trainee engagement with lapa-roscopic simulation training.