BACKGROUND Laparoscopic suturing and knot tying is essential for advanced laparoscopic procedures and requires training outside of the operating room. However, personal instruction by experienced surgeons is limitedly available. To address this, the concept of combining e-learning with practical training has become of interest. This study aims to investigate the influence of the first-person perspective in instructional videos, as well as the feasibility of a completely self-directed training curriculum for laparoscopic suturing and knot tying. MATERIALS AND METHODS Ninety-one laparoscopically naïve medical students were randomised into two groups training with e-learning videos in either the first-person perspective (combining endoscopic view and view of hands/instruments/forearm motion) or the endoscopic view only. Both groups trained laparoscopic suturing and knot tying in teams of two until reaching predefined proficiency levels. Blinded, trained raters regularly assessed the participants' performance by using validated checklists. After training, participants filled out questionnaires regarding training experience and personal characteristics. RESULTS Average training time to reach proficiency did not differ between groups [first-person perspective (min): 112 ± 44; endoscopic view only (min): 109 ± 47; p = 0.746]. However, participants from both groups perceived the first-person perspective as useful for learning new laparoscopic skills. Both groups showed similar baseline performances and improved significantly after training [Objective Structured Assessment of Technical Skills (OSATS) (max. 37 points): first-person perspective: 30.3 ± 2.3; endoscopic view only: 30.8 ± 2.3]. All participants managed to reach proficiency, needing 8-43 attempts without differences between groups. Visuospatial abilities (mental rotation) seemed to enhance the learning curve. CONCLUSION Modifying instructional videos to the first-person perspective did not translate into a better performance in this setting but was welcomed by participants. Completely self-directed training with the use of e-learning can be a feasible training approach to achieve technical proficiency in laparoscopic suturing and knot tying in a training setting.

中文翻译：

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使用第一人称视角进行腹腔镜缝合和打结的电子学习自我指导培训：一项随机对照试验：从医生的真实角度学习。

背景技术腹腔镜的缝合和打结对于高级腹腔镜手术来说是必不可少的，并且需要在手术室外进行培训。但是，经验丰富的外科医生只能提供有限的个人指导。为了解决这个问题，将电子学习与实践培训相结合的概念已经引起人们的兴趣。这项研究旨在调查教学视频中第一人称视角的影响，以及针对腹腔镜缝合和打结的完全自我指导的培训课程的可行性。材料和方法将九十一位腹腔镜天真的医学生随机分为两组，分别以第一人称视角（结合内窥镜视图和手/仪器/手臂运动的视图）或内窥镜视图进行电子学习视频培训。两组均以两人一组的方式训练腹腔镜缝合和打结，直到达到预定的熟练水平。盲人，训练有素的评估者通过使用经过验证的清单定期评估参与者的表现。培训结束后，参与者填写有关培训经历和个人特征的问卷。结果两组之间达到平均水平的平均培训时间没有差异[第一人称视角（分钟）：112±44；仅内窥镜观察（分钟）：109±47; p = 0.746]。但是，两组的参与者都认为第一人称视角对于学习新的腹腔镜技能很有用。两组均表现出相似的基线表现，并在训练后显着改善[技术技能的客观结构化评估（OSATS）（最高37分）：第一人称视角：30.3±2.3；仅内窥镜观察：30.8±2.3]。所有参与者都设法达到了熟练程度，需要进行8-43次尝试，各组之间没有差异。视觉空间能力（心理旋转）似乎可以增强学习曲线。结论在这种情况下，将教学视频修改为第一人称视角并不能带来更好的表现，但受到了参与者的欢迎。使用电子学习进行完全自我指导的培训可能是一种可行的培训方法，可以在培训环境中提高腹腔镜缝合和打结的技术水平。结论在这种情况下，将教学视频修改为第一人称视角并不能带来更好的表现，但受到了参与者的欢迎。使用电子学习进行完全自我指导的培训可能是一种可行的培训方法，可以在培训环境中提高腹腔镜缝合和打结的技术水平。结论在这种情况下，将教学视频修改为第一人称视角并不能带来更好的表现，但受到了参与者的欢迎。使用电子学习进行完全自我指导的培训可能是一种可行的培训方法，可以在培训环境中提高腹腔镜缝合和打结的技术水平。