Updates in Surgery

, Volume 70, Issue 3, pp 401–405 | Cite as

Proficiency-based training of medical students using virtual simulators for laparoscopy and robot-assisted surgery: results of a pilot study

  • Andrea MogliaEmail author
  • Sara Sinceri
  • Vincenzo Ferrari
  • Mauro Ferrari
  • Franco Mosca
  • Luca Morelli
Original Article


Proficiency-based training has become essential in the training of surgeons such that on completion they can execute complex operations with novel surgical approaches including direct manual laparoscopic surgery (DMLS) and robotically assisted laparoscopic surgery (RALS). To this effect, several virtual reality (VR) simulators have been developed. The objective of the present study was to assess and establish proficiency gain curves for medical students on VR simulators for DMLS and RALS. Five medical students participated in training course consisting of didactic teaching and practical hands-on training with VR simulators for DMLS and RALS. Evaluation of didactic component was by questionnaire completed by participating students, who also were required to undertake selected exercises to reach proficiency at each VR simulator: (1) 12 tasks on LapSim VR (Surgical Science, Gothenburg, Sweden) for DMLS, and (2) six selected exercises on the dV-Trainer Mimic (Seattle, WA, United States). The five medical students reached the 60% threshold on the questionnaire-based didactic component. During selected hands-on simulation on VR simulators, students with previous experience with simulators (n = 3) outperformed those without (n = 2) in ten out of twelve LapSim tasks and all six at dV-Trainer, by requiring fewer attempts to reach proficiency although the difference was not significant (p < 0.05). In this work, we developed a proficiency-based training program for medical undergraduates based on surgical simulation for DMLS and RALS.z. Larger studies are needed to evaluate the benefit of this program in stimulating interest for surgical career amongst medical students after the qualify.


Da Vinci simulator Robotic surgery simulator Laparoscopy simulator Proficiency based training 



Fondazione Arpa ( supported the study and donated LapSim and dV-Trainer simulators to EndoCAS Center.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study informed consent is not required.


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Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  • Andrea Moglia
    • 1
    Email author
  • Sara Sinceri
    • 1
  • Vincenzo Ferrari
    • 1
    • 2
  • Mauro Ferrari
    • 1
  • Franco Mosca
    • 1
  • Luca Morelli
    • 1
    • 3
  1. 1.EndoCAS, Center for Computer Assisted SurgeryUniversity of PisaPisaItaly
  2. 2.Information Engineering DepartmentUniversity of PisaPisaItaly
  3. 3.Multidisciplinary Center of Robotic SurgeryCisanello HospitalPisaItaly

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