Ambidexterity in laparoscopic surgical skills training.

Understanding the way in which specialized medical skills are acquired is critical for developing effective training curricula, as well as effective metrics and methodologies for assessing skill acquisition, proficiency, and retention. Currently, a need exists for novel, objective metrics to support training and assessment of specialized surgical skills, such as those involved in laparoscopy, and to support a deeper understanding of the way in which these skills are acquired and decay during periods of nonuse. Ambidexterity has been identified by expert surgeons as a critical factor in the achievement of laparoscopic psychomotor surgical skill proficiency; however, the current standardized training and assessment protocols do not measure or account for differential performance between the dominant and non-dominant hands. Two experiments compared performance with the left and right hands during training of laparoscopic psychomotor surgical skills using the Fundamentals of Laparoscopic Surgery (FLS) platform, examining the role of ambidexterity in skill acquisition and proficiency. The results of these investigations indicate that degree of ambidexterity in task performance increases with overall task performance improvement and may be related to achievement of task proficiency. Measures that account for degree of task-related ambidexterity may provide useful metrics for assessing laparoscopic surgical skill acquisition, proficiency, and decay.