Assessing Learner Growth on a Low-cost Laparoscopic Simulation Platform

Background: Limited infrastructure and training opportunities hinder the adoption of laparoscopy in resource-constrained settings. Simulation-based training platforms offer alternative solutions, but their effectiveness in fostering skill progression across multiple modules is unclear. The ALL-SAFE team developed a free, open-source laparoscopic surgery training platform. Preliminary findings demonstrated cognitive and psychomotor skill acquisition after completing a single module. This study evaluates learners’ longitudinal skill progression across multiple modules. Methods: This retrospective study analyzed performance data collected in Sub-Saharan Africa and in the United States from August 2021 to December 2023. Performance measures included a Verification of Proficiency (VOP) task list, a 5-point global rating scale (GRS), and a final competency rating. Statistical analyses assessed skill differentiation by experience level and progression across modules Results: Among 52 participants (23 Novices, 20 Intermediates, 9 Experts), mean VOP task list scores did not significantly vary by experience, P > 0.05. However, mean global ratings improved with experience (Novices = 58.2%, Intermediates = 68.2%, Experts = 80.3%; P < 0.001). The final competency rating discriminated effectively among groups, with experts scoring highest and novices lowest, P < 0.04. Performance measures positively correlated with module completion rate, ρ = 0.42, P < 0.001, with an increase in VOP task list (87.30% to 90.97%), all five global ratings, and the final competency rating, after completion of four modules, P < 0.001. Conclusion: ALL-SAFE’s simulation platform effectively differentiates skill levels and demonstrates proficiency growth with module progression, supporting its potential as a scalable training tool for laparoscopic surgery.