Article Text

Characteristics of participants who withdraw from surgical simulation-based educational research
  1. Camila Vega Vega1,2,
  2. Hannah Claire Gostlow1,2,
  3. Nicholas Marlow1,2,
  4. Wendy Babidge1,2,
  5. Guy Maddern1,2
  1. 1Discipline of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
  2. 2Australian Safety and Efficacy Register of New Interventional Procedures—Surgical (ASERNIP-S), Royal Australasian College of Surgeons, North Adelaide, South Australia, Australia
  1. Correspondence to Professor Guy Maddern, Discipline of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Woodville, SA 5005, Australia; guy.maddern{at}


Introduction The problems associated with recruitment and retention of patients in clinical trials have been widely addressed in literature; however, similar problems associated with healthcare workers are rarely reported. The aim of this paper is to outline the factors that can impede a participant’s successful participation in a research project and to analyse the characteristics of participants that withdrew.

Methods The Laparoscopic Simulation Skills Program (LSSP) was a prospective randomised cohort study investigating the efficacy of self-directed learning for basic laparoscopic skills acquisition. Two hundred and seven medical students, junior doctors, as well as surgical and gynaecology trainees were enrolled between June 2015 and November 2016.

Results Fifty-six (27%) participants failed to attend the final assessment. Of these, 43 participants (77%) responded to the follow-up survey and/or phone contact regarding non-attendance. Most participants failed to attend due to lack of free time/conflicting clinical duties and university requirements. Participants who did not attend the final assessment and did not provide further responses were less motivated by a career in surgery, surgical simulation and perceived less benefits of laparoscopic simulation. The 43 participants who answered the survey and/or phone contact provided similar responses to the participants who completed the study requirements and had more intrinsic motivators to enrol.

Conclusions Clinical duties and other educational commitments are the biggest barriers to participation in simulation based-education research.

  • surgical education
  • simulation-based education
  • simulation-based learning
  • surgical research
  • simulation training

Statistics from


  • Contributors CVV, HCG: conception of the work, acquisition and interpretation of data, drafting and critically revising, final approval and accountable for work. NM: conception of the work, interpretation of data, drafting and critically revising, final approval and accountable for work. WB, GM: conception of the work, critically revising, final approval and accountable for work.

  • Funding This research was supported by funding from the James and Diana Ramsay Foundation ‘James Ramsay Project Grant’.

  • Competing interests None declared.

  • Ethics approval Ethics approval was granted by the Human Research Ethic Committee at the Queen Elizabeth Hospital (HREC/15/TQEH/76) under National Mutual Acceptance (NMA). Individual ethics approval was granted by individual hospitals where NMA was not recognised. Research Governance Approval was obtained from all hospitals prior to site access.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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