Materials
Tissue damage, ‟Needle
PAD, BITE
The study was performed on a Szabo–Berci–Sackier box trainer and a standard laparoscopy tower (KARL STORZ GmbH & Co. KG, Tuttlingen, Germany). Participants sutured with two laparoscopic needle holders and a braided, absorbable Polysorb 3-0 suture with CV-25 cone ½ 22-mm needle (Medtronic Minimally Invasive Therapies TM, Minneapolis, MN, USA) shortened to 12 cm on a fixed silicone suture pad with predefined entry and exit points (Big Bite Medical GmbH, Heidelberg, Germany).Coping videos used in this study were designed specifically for this purpose [Content and main focus of the coping videos [1. ‟Needle load”  (a) Improper needle loadGrasp needle 2/3 from tip and perpendicular to needle holder(i) Directly from the silicone pad(ii) Allow needle to stand up with light pressure into tissue with needle holder slightly open(iii) Rotate needle in front of camera to check orientation12Pull the thread to the starting position(i) On the silicone pad(ii) With needle loosely gripped by non-dominant hand2. ‟Tissue and instrument handling”  (a) Traumatic tissue handlingPierce at a 90° anglePierce by slightly rotating the wrist to follow the shape of the needle347891011153. “Tail length”  (a) Tissue damage due to incisionFor pulling through, deflection principle, keep thread end as short as possible, grip in rear third(If necessary, loosen knot again first)454. ‟Needle orientation during knot tying”  (a) Wrapping not possibleRegrasp or bring needle to appropriate angle(i) With rotational movement of the instrument/wrist(ii) With needle loosely grasped with non-dominant hand by pulling on thread Clean C-loop7897895. “Lift and drift”  (a) Grasped needle leaves field of view7891115In addition, validated questionnaires were used to survey learning psychology parameters, such as current motivation, satisfaction with own performance, and self-efficacy [