Gamification in laparoscopic training: a randomized, controlled study

Abstract Background: The gamification of laparoscopy using physical computing is an attempt to incentivize training and generate data for analysis. Here, we evaluate a laparoscopic dexterity game box (LDGB) in a pelvitrainer model for laparoscopic training by comparing the performance of the validated Laparoscopic Skills Training and Testing 3 (LASTT 3) exercise from the Gynaecological Endoscopic Surgical Education and Assessment (GESEA) program. Methods: Sixty medical students with no experience in laparoscopy were randomized into three groups with 20 participants in each. All three groups performed four runs of the validated LASTT 3 exercise. Group A completed 40 runs with the LDGB, Group B completed 20 runs, and Group C completed no runs. Task completion time and the number of errors made were recorded. The Wilcoxon test and mixed-effects models were used to analyze the results. After completing the exercises, participants answered questions concerning the LDGB and their performance. Results: The students improved their performance after using the LDGB. They were significantly faster at performing the LASTT 3 exercise using the LDGB, with a mean difference of 40s (P=0.013) between Group A (185s) and Group C (225s), and 26s (P=0.105) between Group B (199s) and Group C (225s). There were no significant differences between the mistakes made. The students were significantly faster (P<0.001) in completing the LDGB exercise during a second repetition, with fewer mistakes made (P<0.001). The LDGB was rated as intuitive by 86.4% of the participants. Conclusions: Students using the LDGB achieved better results in the GESEA exercise. These benefits were accompanied by subjective advantages noted by the students. Gamification presents an opportunity to improve laparoscopic performance.