Mirjam Kaijser

RESULTS Baseline characteristics of the participants are shown in Table 1. Two participants did not practice during the first week of the training experiment. As shown in Table 2, the residents estimated the baseline rope measurements with an absolute deviation of 10% [5-22] from the goal length. Second and final rope measurements showed similar results of 9% [6-21] and 11% [7-18] deviation (P = 1.0). The duration of the rope measurements was similar at the start, during, and after the training experiment (P = 0.5) At baseline, surgical residents estimated small bowel length with an absolute deviation of 21% [9-30] (Figure 3). After completing the training experiment, all residents combined estimated bowel length with an absolute deviation of 8% [2-20]. However, this difference of 13% was not statistically significant (Z = -1.38, P = 0.17). As shown in Figure 3b, residents with sufficient practice of at least 15 minutes in each week of the study (n=8) estimated the baseline bowel measurements with an absolute deviation of 24% [14-38]. These residents improved their measurements statistically significantly to 5% [2-17] deviation after the training experiment (Z=-2.5, P = 0.012). In total, the surgical residents estimated baseline measurements 11 of 30 times (37%) between the acceptable lower and upper margins of 10% deviation. After the training experiment, the residents estimated 19 of 30 times (63%) between the 10% margins. Baseline bowel measurement time was 2:29 minutes, which did not significantly differ from the time of 2:01 minutes after the training experiment (P = 0.28). Table 1: Participant Demographics Sex Age Lap experience Days of training Minutes of training Resident 1 Male 31 10 1 15 Resident 2 Male 34 80 2 30 Resident 3 Female 31 0 3 50 Resident 4 Female 25 0 4 60 Resident 5 Female 34 80 4 60 Resident 6 Male 31 2 4 60 Resident 7 Male 29 0 4 80 Resident 8 Female 28 0 6 95 Resident 9 Female 32 75 6 96 Resident 10 Male 31 30 7 100 Lap experience = laparoscopic experience expressed as number of individually performed laparoscopic surgeries. 138 7

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