Open Access Study protocol

Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized educational trial

Jeanett Oestergaard1*, Flemming Bjerrum2, Mathilde Maagaard1, Per Winkel3, Christian Rifbjerg Larsen2, Charlotte Ringsted4, Christian Gluud3, Teodor Grantcharov5, Bent Ottesen1 and Jette Led Soerensen1

Author Affiliations

1 Department of Obstetrics and Gynecology, Juliane Marie Centre, Centre for Women, Children and Reproduction, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark

2 Department of Obstetrics and Gynecology, Hillerød Hospital, Dyrehavevej 29, Hillerød 3400, Denmark

3 Copenhagen Trial Unit, University of Copenhagen, Dept, 33.44, Blegdamsvej 3b, Copenhagen 2200, Denmark

4 Centre of Clinical Education, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark

5 Department of Surgery, St. Michael's Hospital, University Hospital of Toronto, 30 Bond St., ON M5B 1W8 Toronto, Ontario, Canada

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BMC Medical Education 2012, 12:7  doi:10.1186/1472-6920-12-7

Published: 28 February 2012



Several studies have found a positive effect on the learning curve as well as the improvement of basic psychomotor skills in the operating room after virtual reality training. Despite this, the majority of surgical and gynecological departments encounter hurdles when implementing this form of training. This is mainly due to lack of knowledge concerning the time and human resources needed to train novice surgeons to an adequate level. The purpose of this trial is to investigate the impact of instructor feedback regarding time, repetitions and self-perception when training complex operational tasks on a virtual reality simulator.


The study population consists of medical students on their 4th to 6th year without prior laparoscopic experience. The study is conducted in a skills laboratory at a centralized university hospital. Based on a sample size estimation 98 participants will be randomized to an intervention group or a control group. Both groups have to achieve a predefined proficiency level when conducting a laparoscopic salpingectomy using a surgical virtual reality simulator. The intervention group receives standardized instructor feedback of 10 to 12 min a maximum of three times. The control group receives no instructor feedback. Both groups receive the automated feedback generated by the virtual reality simulator. The study follows the CONSORT Statement for randomized trials. Main outcome measures are time and repetitions to reach the predefined proficiency level on the simulator. We include focus on potential sex differences, computer gaming experience and self-perception.


The findings will contribute to a better understanding of optimal training methods in surgical education.


Virtual reality simulation; Laparoscopy; Training; Salpingectomy; Feedback