Human reliability and training in minimally invasive surgery.

Effective training is essential to decrease the number of errors during surgery, especially during minimally invasive surgery. To develop effective training methods, it should be realized that different types of errors exist. Errors can be divided into slips, lapses and mistakes. The type of error very much depends on the complexity of the task performed. Therefore, these error types can be roughly classified to the level of surgeon's behavior which can be modelled using Rasmussen's model of human behavior that distinguishes between skill, rule and knowledge-based behavior. To avoid errors, training methods for the different levels of behavior are needed, having their own objectives, means and needs. To date, training objectives, means and needs are not standardized.