Objective: The aim of this study was to compare the impact of induced bleeding complication training with regular training on a virtual reality laparoscopic (VRL) simulator. Summary of Background Data: Although bleeding complications occur rarely during laparoscopic surgery, they usually arise without warning and may have severe consequences for the patient because complication management training is not currently widespread. Methods: Third-year medical students (n=41) were randomly selected for two curricular courses on how to perform a bimanual task on a VRL simulator. Both the regular training group (RTG) and the induced bleeding complication training (ICT) group performed two regular training sessions and 9 training sessions. For The ICT group the training sessions were with a bleeding complication. Results: The two groups were comparable regarding their initial performance levels and improved significantly in task time and handling economics throughout the course (P <0.001). When a bleeding complication occurred during the initial phase, performance parameters were significantly worse (P <0.05). During a bleeding complication, the ICT group showed a significant improvement in time, handling economics, and blood loss (P <0.001) throughout the training course, whereas the RTG group showed no improvement. Conclusion: Induced complication training has a positive influence on the management of bleeding on the VRL simulator. Structured laparoscopic complication management training should be implemented during surgical education as an add-on to regular procedural training.

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