Poster4-10: THE FUN FACTOR: DO RESIDENTS SPONTANEOUSLY TRAIN WHEN THE TRAINER IS A SERIOUS GAME?
Wouter IJgosse, Msc, Harry van Goor, MD, PhD, FRCS, Jan-Maarten Luursema, PhD; Radboudumc

Background: The ready availability of validated laparoscopic simulators has not resulted in structured, high-volume training. If this poor utilization is caused by a lack of interest on part of trainees, serious gaming principles should improve this situation by making simulator training fun again. We facilitated spontaneous training with the laparoscopic serious game Underground, and compared spontaneous training volume with Underground to training volume of other laparoscopic activities.

Methods: The serious game Underground was installed in the resident offices of the departments of Surgery, Urology, and Gynecology at the Radboud University Medical Center. After one year we compared amount of time spent on playing Underground to time spent voluntary on laparoscopic simulators, mandatory on laparoscopy courses, and time spent in real life laparoscopic surgery. To contextualize the results, subjects completed a five-point Likert-scale face validity questionnaire.

Results: Over one year residents spent on average 5% (20.4 hours) on serious gaming, 3% (10.6 hours) on traditional simulator training, 22% (87 hours) on mandatory training courses, and 70% (270 hours) in real life laparoscopic surgery (fig. 1). Thirty-nine surgical residents and 22 surgical experts completed the face validity questionnaire. Residents and experts think that serious gaming is a valid concept to train laparoscopic skills (mean scores 4.26; 4.41) and agreed that Underground could be used for basic psychomotor laparoscopic skills training. They did not express a preference for gaming over simulation or vice-versa. Participants expressed frustration with several technical aspects of the game and solving these issues might lead to more spontaneous training.

Figure 1

Conclusion: Although serious gaming roughly tripled the volume of non-mandatory training for residents, its contribution to total training was marginal. Residents and experts welcome serious gaming as a new and valid method for laparoscopic skills training. Voluntary training is unlikely to reach the volume necessary for the development of safe and demonstrable laparoscopic skills and thus mandatory, scheduled training courses remain needed.