Abstract Despite the upcoming use of hysteroscopy and increased applicability during the last decades, little work has been done regarding the development of hysteroscopic
training models in comparison to laparoscopy. Camera navi-gation is often perceived to be an easy task, but it is far froman innate ability, especially when an angled optic is used. This study investigated the learning curve of hysteroscopic 30° camera navigation on a new box trainer: Hysteroscopic Skills Training and Testing (HYSTT). This prospective study (Canadian Task Force II-2) enrolled 30 novices (medical students) and ten experts (gynecologists who had performed >100 diagnostic 30° hysteroscopies). All participants per-formed nine repetitions of a 30° camera exercise on the HYSTT. Novices returned after 2 weeks and performed a second series of five repetitions to assess retention of skills. The parameter procedure time and structured observations on performance using the Global Rating Scale provided measure-ments for analysis. The learning curve is represented by im-provement per procedure. Two-way repeated-measures analy-sis of variance was used to analyze learning curves. Effect size (ES) was calculated to express the practical significance of the results (ES ≥0.50 indicates a large learning effect). For both parameters, significant improvements were found in novice performance within nine repetitions. Moderate to large learning effects were established (p