Analysis of laboratory-based laparoscopic colorectal surgery workshops within the English National Training Programme

Abstract

Background

This study aimed to determine and compare the opinions of trainees and trainers attending courses using two simulation models (fresh frozen cadavers or anaesthetized pigs) and to assess trainees’ degree of insight into both the difficulty of different procedures and their operative performance in the simulated environment.

Methods

Trainers and trainees attending the training courses completed questionnaires. Performance was evaluated using the Global Assessment Score (GAS).

Results

Data were collected over a 12-month period from 26 trainers and 77 trainees. The overall satisfaction was high after attendance at either course (4.50 vs. 4.49; p = 0.83). When the opinions of the trainees and trainers in cadaveric and animal courses were compared, the findings rated the animal model as superior in terms of tissue quality (3.97 vs. 3.55; p = 0.02), persistence of air leak (1.43 vs. 2.40; p < 0.001), and lack of disturbance by odor (4.24 vs. 3.41; p < 0.001). The cadaveric model provided more realistic simulation for port placement (4.02 vs. 3.11; p < 0.001) and anatomy (4.25 vs. 3.00; p < 0.001) and was perceived to be superior as a training model (4.53 vs. 3.61; p = 0.001). The trainees demonstrated good insight into procedure difficulty and their operative performance. The trainees and trainers were shown to have a good concordance of scores. The trainees were more inclined to underrate and the peers to overrate their performance.

Conclusions

Trainees appear to have a good insight into procedure difficulty and their ability. Both training models have advantages and disadvantages, but overall, the cadaveric model is perceived to have a higher fidelity and greater educational value.