Page 5 - World Journal of Laparoscopic Surgery

An Interventional Analytic Study
Table 2: Comparison of clinical scores between two study groups
Group
Variable Serious game LC training (n = 22) Traditional LC training (n = 22) p-value
Skills score based on the pre-surgery theory test 84.5 ± 11.1 68.2 ± 17.6 0.021
Number of attempts needed to reach an 80% score
2.51 ± 1.22 4.11 ± 2.2
2.8 ± 1.40 3.9 ± 1.9 0.001
3.61 ± 1.58 4.5 ± 2.01
2.97 ± 1.40 4.17 ± 2.03
For the first attempt skill score
50.1 ± 16.2 43.2 ± 12.1
66.3 ± 11.1 50.33 ± 13.5 0.021
67.2 ± 8.9 51.6 ± 17.6
61.2 ± 36.2 48.37 ± 14.5
Speed operation time (m) 46.5 ± 10.12 63.31 ± 12.25 0.028
Number of attempts needed to complete the opera- 2.11 ± 0.99 2.81 ± 1.2 0.041
tion without complications
Final skills score gained in performing surgery 90.8 ± 9.2 80.1 ± 14.2 0.012
Data are presented as mean ± SD. p <0.05 is considered significant. LC, laparoscopic cholecystectomy

Table 3: Correlation between the final skills score and characteristics their review, all of which reported significant improvement in
features of the participants learning scores following the use of serious games. In 14 out of 18
Pearson publications with a controlled experiment, post-test scores were
Variable correlation p-value significantly higher after serious games training compared to
the conventional teaching methods. They concluded that health
Age −0.12 0.65 professions training using serious games seems efficacious, at least
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Sex 0.085 0.91 in the short term. Similarly, the surgical skill score was significantly
more in the serious game training group of the present study
History of participation in laparoscopic 0.51 0.029
surgery compared with the traditional training group.
Laparoscopic procedures are acknowledged as a significant
Experience in using computer games and 0.11 0.59 source of surgical errors, and therefore, demand special training
educational social networks
to obtain the required experience. There is an expanding trend in
Duration of surgery −0.66 0.001 studies evaluating the efficacy of serious games in laparoscopic
training. Graafland et al. investigated whether serious game training
improves residents’ skills to solve equipment-related problems
and the final skills score (r = 0.061, p = 0.001), as well as between
the mean obtained score and final skills score (r = 0.87, p = 0.001). A during laparoscopic surgery. Thirty-one surgical residents without
significant negative correlation was found between the final skills laparoscopic experience were randomly assigned into either the
score and duration of surgery (r = −0.66, p = 0.001). The history of serious game group (n = 16) or the traditional curriculum. The
participation in laparoscopic surgery was also positively correlated laparoscopy task was performed in a pig model, during which
with the final skills score (r = 0.51, p = 0.029). The correlation of the three scenarios of standardized equipment malfunction occurred.
final skills score with the characteristics features of the participants The serious game group solved more equipment-related problems
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is demonstrated in more detail in Table 3. than the traditional training group (55 vs 33%). We did not evaluate
the skills of residents in solving the equipment malfunctions.
However, residents of the serious game group outperformed the
dIscussIon surgery compared to the traditional training group, which was
In this study, we compared the surgical LC skills between the demonstrated by a higher final skill score of LC performance.
residents who were trained via the serious game and those who Ijgosse et al. evaluated the construct validity of the serious
were trained traditionally. Based on our results, the serious game game Underground for laparoscopic skills. The performance
training group had a higher skill score on the pre-surgical theory was compared between the novices (less than ten prior
test, a lower number of attempts needed to reach an 80% skill laparoscopic experiences), intermediates (10–100 prior laparoscopic
score, shorter surgical duration, lower number of attempts needed experiences), and experts (>100 prior laparoscopic experiences).
to complete the operation without complications, and higher final Prior laparoscopic experiences showed a significant effect on
skills score. The final skills score was significantly correlated with the time variable. The experts and intermediates outperformed
the duration of serious game playing and the mean obtained score. novices regarding the speed task. The rate of gameplay errors
The learning efficacy of serious games for a variety of health showed a similar trend between different groups. Male gender
professions education has been evaluated in earlier studies. 7–12 and prior video game experience were associated with better
Haoran et al. reviewed the studies evaluating the efficacy of serious performance. Accordingly, the construct validity was established
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game training from 1996. A total of 25 studies were included in for the serious game Underground. In comparison with traditional

World Journal of Laparoscopic Surgery, Volume 15 Issue 2 (May–August 2022) 101