Journal of Surgical Simulation 2015; 2: 53 - 59

Published: 30 November 2015


Original article

Home virtual reality simulation training: the effect on trainee ability and confidence with laparoscopic surgery

Jonathan Barnes, Jessica Burns, Craig Nesbitt, Helen Hawkins and Alan Horgan
Corresponding author: Jonathan Barnes, Freeman Hospital, Freeman Road, Newcastle Upon Tyne, NE7 7DN, UK. Email:


Introduction: Virtual reality simulation (VRS) attempts to replicate surgical scenarios and offers performance feedback, making it a valuable training tool. However, VRS use is limited by costs, availability and accessibility. Cheaper portable units may therefore be invaluable. Previous studies have shown face validity for such modalities of training although no study has assessed whether home simulation training actually improves surgical performance.

Methods: Twenty-one surgical trainees were split into practice (n = 10) and control groups (n=11). Both groups performed two simulated laparoscopic cholecystectomies 1 week apart. Data on technical ability (operation time, time taken for gallbladder removal, cautery efficiency and total instrument movements) and safety (cautery safety, complications and perforations) were recorded. Between cholecystectomies, the practice group were given a portable VRS unit to use at home. The practice group were assessed on their procedural confidence before and after training.

Results: The practice group showed significant improvements in operation time (19.02 to 14.96 min, P<0.05) and cautery efficiency (59.8% to 65.1%, P<0.05) between procedures, whereas the control group showed no changes. Further improvements in time taken for gallbladder removal (16.5 to 11.3 min, P<0.05) and instrument movements (979 to 710, P<0.05) were seen in the more experienced trainees. The practice group showed significantly increased procedural confidence, assessed using a visual analogue scale, after training (46.6% to 67.6%, P<0.01).

Discussion: This study shows that home simulation training significantly improves trainees’ confidence and laparoscopic skills. Further studies are needed to develop understanding of how best to utilize this potentially valuable surgical training tool.


Simulation; home simulation; portable simulator; training; education