***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To develop and vali date a comprehensive ex vivo training curriculum for laparoscopic colorectal surgery . Background : Simulators have been shown to be viable systems for teaching technical skills outside the operating room ; however , integration of simulation training into comprehensive curricula remains a major challenge in modern surgical education . Currently , no curricula have been described or vali date d for advanced laparoscopic procedures . Methods : This prospect i ve , single-blinded r and omized controlled trial allocated 25 surgical residents to receive either conventional residency training or a comprehensive training curriculum for laparoscopic colorectal surgery .  The curriculum consisted of proficiency-based psychomotor training on a virtual reality simulator , cognitive training , and participation in a cadaver lab . The primary outcome measure in this study was surgical performance in the operating room . All participants performed a laparoscopic right colectomy  , which was video recorded and assessed using 2 previously vali date d assessment tools . Secondary outcome measures were knowledge relating to the execution of the procedure , assessed with a multiple-choice test , and technical performance on the simulator . Results : Curricular-trained residents demonstrated superior performance in the operating room compared with conventionally trained residents ( global score 16.0 [ 14.5–18.0 ] versus 8.0 [ 6.0–14.5 ] , P = 0.030 ; number of operative steps performed 16.0 [ 12.5–17.5 ] versus 8.0 [ 6.0–14.5 ] , P = 0.021 ; procedure-specific score 71.1 [ 54.4–81.6 ] versus 51.1 [ 36.7–74.4 ] , P = 0.122 ) . Curricular-trained residents scored higher on the multiple-choice test ( 10 [ 9–11 ] versus 7.5 [ 5.3–7.5 ] , P = 0.047 ) , and outperformed conventionally trained residents in 7 of 8 tasks on the simulator . Conclusions : Participation in a comprehensive ex vivo training curriculum for laparoscopic colorectal surgery results in improved technical knowledge and improved performance in the operating room compared with conventional residency training . Reg . ID#NCT 01371136 BACKGROUND The efficacy of laparoscopy simulators remains controversial . METHODS This was a comparative prospect i ve study that evaluated the impact of  simulator training  on technical competence during a real surgical procedure . Residents were divided into 3 groups : the Mcgill Inanimate System for Training and Evaluation of Laparoscopic Skills ( MISTELS ) group , training on a simple simulator ; LAP Mentor group , training on a virtual simulator ; and control group . An initial evaluation was made by a vali date d score during a laparoscopic cholecystectomy . Each resident was then trained for 1 month . A second evaluation was then performed . RESULTS Before/after scores were significantly improved in the MISTELS ( P = .042 ) and LAP Mentor ( P = .026 ) groups . It was not the case in the control group . There was a better progression in the MISTELS ( P = .026 ) and LAP Mentor ( P = .007 ) groups than in the control group . There was no significant difference between the MISTELS and LAP Mentor groups . CONCLUSIONS Simulator training provides a more rapid acquisition of competence in surgical technique BACKGROUND Developing technical skill is essential to surgical training , but using the operating room for basic skill acquisition may be inefficient and expensive , especially for laparoscopic operations . This study determines if laparoscopic skills training using simulated tasks on a video-trainer improves the operative performance of surgery residents . STUDY DESIGN Second- and third-year residents ( n= 27 ) were prospect ively r and omized to receive  formal laparoscopic skills training  or to a control group . At baseline , residents had a vali date d global assessment of their ability to perform a laparoscopic cholecystectomy based on direct observation by three evaluators who were blinded to the residents ' r and omization status . Residents were also tested on five st and ardized video-trainer tasks . The training group practice d the video-trainer tasks as a group for 30 minutes daily for 10 days . The control group received no formal training . All residents repeated the video-trainer test and underwent a second global assessment by the same three blinded evaluators at the end of the 1-month rotation . Within-person improvement was determined ; improvement was adjusted for differences in baseline performance . RESULTS Five residents were unable to participate because of scheduling problems ; 9 residents in the training group and 13 residents in the control group completed the study . Baseline laparoscopic experience , video-trainer scores , and global assessment s were not significantly different between the two groups . The training group on average practice d the video-trainer tasks 138 times ( range 94 to 171 times ) ; the control group did not practice any task . The trained group achieved significantly greater adjusted improvement in video-trainer scores ( five of five tasks ) and global assessment s ( four of eight criteria ) over the course of the four-week curriculum , compared with controls . CONCLUSIONS Intense training improves video-eye-h and skills and translates into improved operative performance for junior surgery residents . Surgical curricula should contain laparoscopic skills training Objective : To assess the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills ( MISTELS ) physical laparoscopic simulator for construct and predictive validity and for its educational utility . Summary Background Data : MISTELS is the physical simulator incorporated by the Society of American Gastrointestinal and Endoscopic Surgeons ( SAGES ) in their Fundamentals of Laparoscopic Surgery ( FLS ) program . MISTELS ’ metrics have been shown to have high interrater and test-retest reliability and to correlate with skill in animal surgery . Methods : Over 200 surgeons and trainees from 5 countries were assessed using MISTELS in a series of experiments to assess the validity of the system and to evaluate whether practicing MISTELS basic skills ( transferring ) would result in skill acquisition transferable to complex laparoscopic tasks ( suturing ) . Results : Face validity was confirmed through question ing 44 experienced laparoscopic surgeons using global rating scales . MISTELS scores increased progressively with increasing laparoscopic experience ( n = 215 , P < 0.0001 ) , and residents followed over time improved their scores ( n = 24 , P < 0.0001 ) , evidence of construct validity . Results in the host institution did not differ from 5 beta sites ( n = 215 , external validity ) .  MISTELS scores correlated with a highly reliable vali date d intraoperative rating of technical skill during laparoscopic cholecystectomy ( n = 19 , r = 0.81 , P < 0.0004 ; concurrent validity ) . Novice laparoscopists were r and omized to practice /no practice of the transfer drill for 4 weeks . Improvement in intracorporeal suturing skill was significantly related to practice but not to baseline ability , career goals , or gender ( P < 0.001 ) . Conclusion : MISTELS is a practical and inexpensive inanimate system developed to teach and measure technical skills in laparoscopy . This system is reliable , valid , and a useful educational tool This study examined the impact of virtual reality ( VR ) surgical simulation on improvement of psychomotor skills relevant to the performance of laparoscopic cholecystectomy OBJECTIVE ( S ) Patient-specific simulated rehearsal ( PsR ) is a technological advance within the domain of endovascular virtual reality ( VR ) simulation . It allows incorporation of patient-specific computed tomography Digital Imaging and Communications in Medicine ( CT DICOM ) data into the simulation and subsequent rehearsal of real patient cases . This study aim ed to evaluate whether a part-task rehearsal ( PTr ) of a carotid artery stenting procedure ( CAS ) on a VR simulator is as effective as a full-task ( FTr ) preoperative run through . METHODS Medical trainees were trained in the CAS procedure and r and omised to a PTr or FTr of a challenging CAS case ( Type-II arch ) . PTr consisted of 30 min of repeated catheterisations of the common carotid artery ( CCA ) . Thereafter , both groups performed the CAS procedure in a fully functional simulated operating suite ( SOS ) with an interventional team . Technical performances were assessed using simulator-based metrics and expert ratings . Other aspects of performance were assessed using the Non-Technical Skills for Surgeons ( NOTSS ) scoring . RESULTS Twenty trainees were evenly r and omised to either PTr or FTr . No differences in performance were seen except for the total time the embolic protection device ( EPD ) was deployed ( 9.4 min for the PT vs. 8.1 min for the FT , p = 0.02 ) . Total time ( 26.3 vs. 25.5 min , p = 0.94 ) , fluoroscopy time ( 15.8 vs. 14.4 min , p = 0.68 ) , number of roadmaps ( 10.5 vs. 11.0 , p = 0.54 ) , amount of contrast ( 53.5 vs. 58.0 ml , p = 0.33 ) , time to deploy the EPD ( 0.9 vs. 0.8 min , p = 0.31 ) and time to catheterise the CCA ( 9.2 vs. 8.9 min , p = 0.94 ) were similar . Qualitative performances as measured by expert ratings ( score 24 vs. 24 , p = 0.49 ) and NOTSS ( p > 0.05 for all categories ) were also comparable . CONCLUSIONS Part- and full-task rehearsals are equally effective with respect to the operative performance of a simulated CAS intervention . This finding makes a patient-specific rehearsal more efficient and may increase the feasibility of implementation of this technology into medical practice Objectives : The development of a structured virtual reality ( VR ) training curriculum for colonoscopy using high-fidelity simulation . Background : Colonoscopy requires detailed knowledge and technical skill . Changes to working practice s in recent times have reduced the availability of traditional training opportunities . Much might , therefore , be achieved by applying novel technologies such as VR simulation to colonoscopy . Scientifically developed device-specific curricula aim to maximize the yield of laboratory-based training by focusing on vali date d modules and linking progression to the attainment of benchmarked proficiency criteria . Methods : Fifty participants comprised of 30 novices ( < 10 colonoscopies ) , 10 intermediates ( 100 to 500 colonoscopies ) , and 10 experienced ( > 500 colonoscopies ) colonoscopists were recruited to participate . Surrogates of proficiency , such as number of procedures undertaken , determined prospect i ve allocation to 1 of 3 groups ( novice , intermediate , and experienced ) . Construct validity and learning value ( comparison between groups and within groups respectively ) for each task and metric on the chosen simulator model determined suitability for inclusion in the curriculum . Results : Eight tasks in possession of construct validity and significant learning curves were included in the curriculum : 3 abstract tasks , 4 part-procedural tasks , and 1 procedural task . The whole-procedure task was valid for 11 metrics including the following : “ time taken to complete the task ” ( 1238 , 343 , and 293 s ; P < 0.001 ) and “ insertion length with embedded tip ” ( 23.8 , 3.6 , and 4.9 cm ; P = 0.005 ) . Learning curves consistently plateaued at or beyond the ninth attempt . Valid metrics were used to define benchmarks , derived from the performance of the experienced cohort , for each included task . Conclusions : A comprehensive , stratified , benchmarked , whole-procedure curriculum has been developed for a modern high-fidelity VR colonoscopy simulator PURPOSE : The aim of this study was to compare skills sets during a h and -assisted and straight laparoscopic colectomy on an augmented reality simulator . METHODS : Twenty-nine surgeons , assigned r and omly in 2 groups , performed laparoscopic sigmoid colectomies on a simulator : group A ( n = 15 ) performed h and -assisted then straight procedures ; group B ( n = 14 ) performed straight then h and -assisted procedures . Groups were compared according to prior laparoscopic colorectal experience , performance ( time , instrument path length , and instrument velocity changes ) , technical skills , and operative error . RESULTS : Prior laparoscopic colorectal experience was similar in both groups . Both groups had better performances with the h and -assisted approach , although technical skill scores were similar between approaches . The error rate was higher with the h and -assisted approach in group A , but similar between both approaches in group B. CONCLUSIONS : These data define the metrics of performance for h and -assisted and straight laparoscopic colectomy on an augmented reality simulator . The improved scores with the h and -assisted approach suggest that with this simulator a h and -assisted model may be technically easier to perform , although it is associated with increased intraoperative errors Background Minimally invasive surgery in small children and infants requires special skills and training . This experimental study compares the efficiency of an in vitro pelvic trainer ( PT ) and an a in vivo animal model ( AM ) . Methods For this study , 12 residents were prospect ively r and omized into two groups . Initially , all had to pass a basic skill assessment ( 3 tasks ) . Then endoscopic small bowel biopsy was performed ( 8 times ) either with the in vitro PT ( group A ) or the in vivo AM ( group B ) . Finally , all had to demonstrate this procedure in the in vivo AM and repeat the 
    Output:
    
The retrieved studies showed some encouraging trends in terms of trainee satisfaction with improvement after training , but the improvements were mainly on the training tool itself .
Some tools have been proven to be construct-valid .