The role of proximate feedback in skills training.

Skills training has been an increasingly important focus of surgical training and is ideally performed prior to reaching the operating room. Although our understanding of the role is increasing, and there are more publications describing endpoints with simulation and different training models, the optimal training methodology remains unclear. In this paper we discuss our experience with simulation and a variety of training models, primarily for teaching laparoscopic colorectal resection. Feedback during training is likely important, and the more proximate that feedback, the better its effectiveness. Optimal skills' training likely depends on a combination of having the optimal curriculum, in conjunction with an appropriate training model.