Exploring trainee experiences in a structured virtual reality laparoscopic training programme for general surgeons: a longitudinal case study.

BACKGROUND: The acquisition and maintenance of technical skills in surgical specialties has become increasingly challenging for postgraduate trainees, exacerbated by factors such as the shift from traditional apprenticeship models, reduced operative time, and the impact of the COVID-19 pandemic. Virtual reality (VR) simulators offer a promising adjunct to traditional surgical training, though their integration into routine practice remain underexplored. OBJECTIVE: This qualitative study investigates the experiences and motivations of general surgical trainees who engaged with a VR laparoscopic simulator as part of a structured training program. METHODS: A case study methodology was chosen to explore the experiences of 22 general surgery trainees using a VR laparoscopic simulator over a period of 3 months. Each of the trainees were adviced to practise a minimum of five repetitions across 25 laparoscopic simulator exercises. The study was designed using Kopta's theory of technical skill learning, focusing on the cognitive phase, where trainees repetitively practised individual steps with feedback. Data collection involved qualitative questionnaires, semi-structured interviews (of seven of the trainees, 8 months later), and quantitative data from the simulator. The qualitative data was analysed using thematic analysis, and descriptive statistical tests were applied to the quantitative data for triangulation. RESULTS: The study identified key factors influencing trainee engagement, including ease of access, the importance of periodic rather than frequent simulation sessions, Annual Review of Competency Progression (ARCP) overview and the value of setting specific performance goals. The findings suggest that simulation can effectively complement traditional surgical training when incorporated into routine practice, with potential for broader application if barriers such as time constraints and access issues are addressed. CONCLUSION: This study contributes to the literature on surgical education by highlighting the need for targeted strategies to enhance the use of simulation as an adjunct alongside more traditional training.