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VR for improved performance of MIS is now a reality. However, VR is only a training tool that must be thoughtfully introduced into a surgical training curriculum for it to successfully improve surgical technical skills.

Currently, no optimal curriculum exists for the Fundamentals of Laparoscopic Surgery (FLS) manual skills training program. The objective was to create a proficiency-based training curriculum that would allow both successful completion of the FLS manual skills exam and improved performance in the operating room. Two experienced laparoscopic surgeons performed 5 consecutive repetitions of all 5 FLS tasks. The mean performance times for both subjects were determined. Error parameters for each task were also recorded and used to establish a maximum allowable error parameter for each task. These data were used to create both error- and time-based proficiency levels for each task based on the importance of the task and the amount of resources consumed when practicing the task. This type of objective proficiency level was determined for each of the 5 FLS tasks. We have developed a proficiency-based training curriculum for the psychomotor skills portion of FLS. Work is under way to evaluate and validate this curricular design.

This proficiency-based curriculum is feasible for training novices and uniformly allows sufficient skill acquisition for FLS certification. Endorsed by the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), this curriculum is available for use as an optimal method for FLS skills training. More widespread adoption of this curriculum is encouraged.

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