Background: The purpose of this study was to determine the impact of instructor feedback and video tutorials on skill acquisition during proficiency-based laparoscopic suturing training. Methods: Performance data from a prospectively maintained database were reviewed for three groups of novices (n = 34 medical students) who completed the same proficiency-based laparoscopic suturing curriculum on a Fundamentals of Laparoscopic Surgery-type videotrainer model as part of two separate institutional review board-approved, randomized controlled trials. Group I (n = 9) watched the video tutorial once and received intense feedback during each training session; Group II (n = 13) watched the video tutorial once and received limited feedback (<10 min per session); Group III (n = 12) watched the video tutorial several times and also received limited feedback (<10 min per session). Feedback was given by the same instructor and was quantified on a 0 (none) to 4 (extensive) Likert scale. Results: Baseline characteristics were similar for all groups. All participants achieved the proficiency level (512) on two consecutive attempts. Group III required the shortest training time and number of repetitions to reach proficiency, with statistically significant differences compared with Group I (P < 0.02). This strategy led to a cost savings of $139 per trainee. Conclusions: Limited instructor feedback appears to be superior to intense feedback during proficiency-based laparoscopic simulator training. Coupled with video tutorials, this type of feedback may accelerate learning and improve resource utilization by minimizing the need for instructor involvement.
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