Proficiency-based laparoscopic simulator training leads to improved operating room skill that is resistant to decay

The aim of this study was to assess skill retention in the operating room following completion of a proficiency-based laparoscopic skills curriculum. Novices (n = 15) were randomized to a control and a training group that practiced to proficiency on the Fundamentals of Laparoscopic Surgery suturing model. The performance of both groups was assessed on the simulator and on a live porcine laparoscopic Nissen fundoplication model at training completion (posttest) and 5 months later (retention test). Training to proficiency required 4.7 +/- 1.2 hours and 41 +/- 10 repetitions. Trained participants outperformed controls, and their performance deteriorated slightly between posttests and retention tests on the simulator (505 +/- 22 vs 462 +/- 50, respectively; P <.05) but not in operating room (263 +/- 138 vs 279 +/- 88, respectively; P =.38). Proficiency-based simulator training results in durable improvement in operative skill of trainees even in the absence of practice for up to 5 months. Minute simulator performance changes do not translate to the operating room.