Take-home laparoscopic simulators to develop surgical skills: Analysing attitudes to, and barriers and enablers of, their use in gynaecology training


  • Erin Wilson Mater Health
  • Brian Jolly University of Newcastle
  • Michael Beckmann Mater Health
  • Sarah Janssens Mater Education, Mater Health
  • David Hewett University of Queensland Faculty of Medicine
  • Shelley Wilkinson Mater Health




curriculum, education, medical, gynaecology, laparoscopy, simulation training, Theoretical Domains Framework



 Introduction: Providing specialty trainees with take-home laparoscopic simulators may overcome known barriers to simulation-based surgical training such as limited time and access to equipment; however, programs utilising these simulators have reported suboptimal engagement from trainees. The purpose of this study was to understand factors influencing the use of take-home laparoscopic simulators and make suggestions to optimise engagement in future programs. 

Methods: We interviewed 10 of the 16 gynaecology trainees who participated in a take-home laparoscopic box trainer simulation program. Interview transcripts were analysed and themes sorted using the Theoretical Domains Framework. Articulation of these domains with the Behaviour Change Wheel directed the formulation of targeted interventions. 

Results: Trainees had positive attitudes towards simulation training; however, they experienced numerous under-recognised barriers to training. Trainees found their professional role, duties and competing life priorities limited time for training. Trainees experienced feelings of inertia and did not train as much as they anticipated. They were disengaged from training by a lack of real operating, a perceived poor relationship between training tasks and surgery and difficulties with equipment set-up. Self-directed practice, goal setting, task deadlines, perceived supervision, a recognition of personal skill development and an understanding of the need for simulation enabled training. Interventions were proposed to address the barriers to training.

Conclusions: Trainee attitudes towards simulation and take-home trainers were positive, yet numerous barriers prevented them from training. Following a theory-driven process, we were able to devise targeted, evidence-based interventions, which may be incorporated into future versions of the program.

Author Biographies

Brian Jolly, University of Newcastle

Professor of Medical Education (JMP)

School of Medicine & Public Health, Faculty of Health and Medicine.


Adjunct Professor, School of Rural Medicine, University of New England.

Head of Discipline: Medical Education

Chair: JMP Assessment Committee

Michael Beckmann, Mater Health

Director Mothers, Babies and Women’s Health Services, Mater Health

Sarah Janssens, Mater Education, Mater Health

Clinical Simulation Director / Staff Specialist Obstetrics and Gynaecology

Shelley Wilkinson, Mater Health

Dr Shelley Wilkinson is an Advanced Accredited Practising Dietitian and is the Senior Research Dietitian in the Mater Mothers’ Hospitals. She is recognised as a leading Australian researcher in maternal health and in implementation science.


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How to Cite

Wilson, E., Jolly, B., Beckmann, M., Janssens, S., Hewett, D., & Wilkinson, S. (2019). Take-home laparoscopic simulators to develop surgical skills: Analysing attitudes to, and barriers and enablers of, their use in gynaecology training. Focus on Health Professional Education: A Multi-Professional Journal, 20(3), 44–64. https://doi.org/10.11157/fohpe.v20i3.352