Effect of a mobile-based cognitive simulator (Touch Surgery) on knowledge, simulated scrub-role performance, and perceived perioperative competence among operating room technology students: a randomized controlled trial

Surgical training is confronted with structural limitations, which have prompted worldwide movement towards mobile cognitive simulators. The aim of the current study was to investigate the effect of the use of the Touch Surgery simulator on knowledge of surgical procedures, clinical practice skills, perceived competence, and safety attitudes in operating room technology students performing laparoscopic cholecystectomy. A two-group parallel randomized controlled trial with repeated measurements was adopted in the study with 80 OR technology undergraduates allocated to the experimental group (n=40; Touch Surgery simulator + traditional training) and the control group (n=40; traditional training only). Data were collected at baseline, immediately after the intervention, and 4 weeks later. The study utilized several measures of knowledge test based on a previously validated instrument, Skill Lab observational checklist, Perceived Perioperative Competence Scale-Revised (PPCS-R), and Safety Attitudes Questionnaire (SAQ). Repeated Measures ANOVA analysis was applied. Equally balanced distribution was revealed for all variables at baseline. Significant time × group interaction effects were found to be associated with superior improvement in the level of knowledge (P<0.001, Partial η²=0.147) and simulated clinical performance (P<0.001, Partial η²=0.195; Cohen's d=1.08) achieved by participants in the experimental group compared to those in the control group. Besides, the increase in perceived competence was considerably faster (P<0.001, Partial η²=0.269) in the experimental group than in the control group. Changes in the scores for the SAQ showed no statistically significant differential changes between groups (P=0.373). It can be concluded that the application of the Touch Surgery simulator represents an effective complement to surgical training, contributing to a rapid improvement in cognitive skills and simulated scrub-role performance, as well as increasing perceived competence in operating room technology students. Nonetheless, it is possible that inducing considerable change in safety attitudes requires the integration of cognitive simulators into team-based clinical environments. UMIN Clinical Trials Registry (UMIN-CTR), UMIN000062522. Registered on 8 August 2026. Retrospectively registered.