Surgeon supervision during training doesn't boost skills faster, study finds
A randomized trial of medical students learning laparoscopic surgery found that real-time instructor oversight provided no performance advantage over independent practice. The finding could reshape how surgical training programs allocate resources and instructor time, potentially freeing experts to supervise more advanced procedures while novices self-direct foundational skills.
Originaltitel: Does supervision matter? A randomized controlled study of laparoscopic simulator training in undergraduate education
Background Simulation-based training is a cornerstone of surgical education, yet evidence regarding the comparative impact of continuous instructor supervision vs. independent practice for novices remains limited. This study aimed to assess the efficacy of continuous, remote video-guided supervision compared with independent training in laparoscopic simulation for medical students. Methods A randomized controlled trial was conducted with 20 medical students having no prior laparoscopic experience. Participants were randomized to either a supervision group ( n = 8), receiving real-time video-guided instruction, or an independent group ( n = 12) engaging in self-directed practice. Training was performed using the Simball Box simulator (“Rope Race” task). Outcome measures included objective task completion times and subjective ratings of perceived difficulty and feedback value via questionnaires. Results Both groups demonstrated significant improvement in procedure times from warm-up to the first exercise (Supervised: p < 0.001; Independent: p = 0.020). While no statistically significant difference was found between groups in the primary outcome (performance time in the first unsupervised Rope Race test) the supervised group trended towards faster completion in early exercises. Notably, the supervised group reported significantly lower perceived difficulty post-training ( p = 0.049), whereas the independent group perceived a significant reduction in the value of simulator-only feedback ( p = 0.003). Conclusion Remote real-time supervision significantly reduces perceived difficulty and prevents the devaluation of feedback compared to independent practice. These findings support a hybrid curricular model where resource-intensive supervision is front-loaded to facilitate early psychomotor skill acquisition, followed by independent volume training.