Structured Laparoscopic Training and Its Impact on Enhancing Ambidexterity in Novice Medical Students

University of Nebraska Medical Center

Introduction: Ambidexterity is a crucial skill for performing surgery, but novice trainees often struggle to utilize their non-dominant hands appropriately. This study's primary objectives were to evaluate the development of laparoscopic skills by assessing subjective workload and time to complete a Fundamentals of Laparoscopic Surgery (FLS) task with an emphasis on the use of both hands. Methods: Medical students with no previous experience in in laparoscopic skills were enrolled. A standardized video demonstrating the intra-corporeal knot-tying task was provided. Each student completed a pre-test where they performed the task with their dominant hand (DH) and non-dominant hand (NDH). Each student then completed four 15-minute unsupervised practice sessions within 1 week, focusing on skill enhancement solely in the NDH, and then completed a post-test where they performed the same task again. Each performance was timed, and after completion, the NASA Task Load Index (NASA-TLX) was administered to evaluate perceived workload and task difficulty using DH and NDHs. Statistical analysis was completed using Wilcoxon Signed Ranks test. Results: Ten students participated. The mean performance time in the DH was reduced from 496.1 to 254.2 seconds, and in the NDH, from 451.8 to 260.8 seconds (p = 0.005 and 0.007, respectively). Composite NASA-TLX scores decreased from 69.6 to 55.5 for the DH and from 69.6 to 55.4 for the NDH (p = 0.009 and 0.022, respectively). When comparing pre-test DH to NDH and post-test DH to NDH, no significant differences were observed for performance time or NASA-TLX scores. Conclusion: This study highlights the effectiveness of structured laparoscopic training in enhancing the surgical skills of novice students. Both DH and NDHs showed significant improvement in performance time and a reduction in perceived workload, indicating its potential in fostering ambidexterity among medical trainees. Further analyses are being performed to determine if objective performance differences exist following the training schedule.