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Standardized visual overlays enhance laparoscopic instruction: A mixed-methods evaluation.

Cassandra Barber·Jen Hoogenes·Kikachukwu Otiono·Kevin Kim·Bobby Shayegan·Kevin Piercey·Edward D Matsumoto
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Abstract

Effective communication during laparoscopic procedures is frequently undermined by spatial disorientation and inconsistent terminology between instructors and trainees. This study examined whether standardized visual overlays on endoscopic monitors could enhance communication and learning. We conducted a three-phase mixed-methods study: qualitative observation of 20 laparoscopic teaching cases; a randomized trial of 63 second-year medical students assigned to control, clock, or alphanumeric grid (AG) overlays during three trials of a standardized transfer task; and intraoperative implementation in 44 cases (30 AG, 14 clock) with post-case surveys and qualitative feedback. In simulation, the clock overlay produced the fastest completion times, whereas the AG yielded the lowest error scores, and both overlays outperformed the control. Intraoperatively, the AG was rated higher than the clock for communication clarity, spatial orientation, perceived operative efficiency, and trainee confidence. Standardized visual overlays, particularly the AG, appear to support intraoperative teaching by providing a shared spatial frame of reference.

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LaparoscopyHumansClinical CompetenceCommunicationSimulation TrainingMaleFemaleCompetency-based trainingIntraoperative communicationLaparoscopic educationMinimally invasive surgerySpatial orientationSurgical simulationJournal ArticleRandomized Controlled Trial

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Cassandra Barber, Jen Hoogenes, Kikachukwu Otiono, Kevin Kim, Bobby Shayegan, Kevin Piercey, Edward D Matsumoto. 2026-06-18. Standardized visual overlays enhance laparoscopic instruction: A mixed-methods evaluation.. https://doi.org/10.1016/j.amjsurg.2026.117107

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Journal Article; Randomized Controlled Trial resourceClinical Competence subjectFemale subjectHumans subjectJournal Article subjectLaparoscopy subjectMale subjectRandomized controlled trials study

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