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Long-term knowledge retention following simulation-based training for electrosurgical safety: 1-year follow-up of a randomized controlled trial

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Abstract

Background

Despite the value of simulation for surgical training, it is unclear whether acquired competencies persist long term. A prior randomized trial showed that structured simulation improves knowledge of the safe use of electrosurgery (ES) amongst trainees up to 3 months after the curriculum (Madani et al. in Surg Endosc 28(10):2772–2782, 2014). We now analyse long-term knowledge retention. This study estimates the effects of a structured simulation-based curriculum to teach the safe use of ES on knowledge after 1 year.

Methods

Trainees previously participated in a 1-h didactic ES course, followed by randomization into one of two groups: an unstructured hands-on session where trainees used ES devices (control group) or a goal-directed hands-on training session (Sim group). Knowledge of pre- and post-curriculum (immediate, 3 months and 1 year) and knowledge of ES safety were assessed using different multiple-choice examinations. Data are expressed as median (interquartile range), *p < 0.05.

Results

Fifty-nine trainees participated (30 control group; 29 Sim group). Despite equal baseline examination scores, Sim group demonstrated higher scores compared to control immediately (89 % [83; 94] vs. 83 % [71; 86]*), 3 months (77 % [69; 90] vs. 60 % [51; 80]*) and 1 year after curriculum (70 % [61; 74] vs. 60 % [31; 71]*). One-year score remained significantly greater compared to baseline in the Sim group (70 % [61; 74] vs. 49 % [43; 57]*), but was similar to baseline in the control group (60 % [31; 71] vs. 45 % [34; 52]).

Conclusions

After ES simulation training, retention of competencies persists longer when the hands-on component is designed to reinforce specific learning objectives in a structured curriculum. Despite routine clinical use of ES devices, knowledge degrades overtime, suggesting the need for ongoing formal educational activities to reinforce curricular objectives.

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Acknowledgments

We acknowledge the SAGES FUSE task force for the development of the FUSE curriculum and presentation slides, as well as the facilitators who assisted in conducting the electrosurgery course. AM is supported by the Quebec Health Science Research Scholarship (FRQ-S) and the McGill Surgeon-Scientist Program.

Disclosures

The Steinberg-Bernstein Centre receives unrestricted educational grants from ConMed and Covidien Canada. Dr. Melina Vassiliou was a consultant for Covidien. Dr. Daniel Jones was a consultant for Intuitive and Allurion. Dr. Steven Schwaitzberg was a consultant for Stryker, Olympus, Human Extension and Acuity Bio. Drs. Amin Madani, Yusuke Watanabe, Pascal Fuchshuber, Gerald M. Fried and Liane S. Feldman have no conflicts of interest or financial ties to disclose. Dr. Amin Madani is supported by the Quebec Health Science Research Scholarship (FRQ-S) and the McGill Surgeon-Scientist Program.

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Authors and Affiliations

  1. Department of Surgery, McGill University, Montreal, QC, H3G 1A4, Canada

    Amin Madani, Yusuke Watanabe, Melina C. Vassiliou, Gerald M. Fried & Liane S. Feldman

  2. Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm L9-309, Montreal, QC, Canada

    Amin Madani, Yusuke Watanabe, Melina C. Vassiliou, Gerald M. Fried & Liane S. Feldman

  3. The Permanente Medical Group, Kaiser Medical Center, Walnut Creek, CA, USA

    Pascal Fuchshuber

  4. Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Daniel B. Jones

  5. Department of Surgery, Cambridge Health Alliance, Cambridge, MA, USA

    Steven D. Schwaitzberg

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  1. Amin Madani
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Correspondence to Amin Madani.

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Madani, A., Watanabe, Y., Vassiliou, M.C. et al. Long-term knowledge retention following simulation-based training for electrosurgical safety: 1-year follow-up of a randomized controlled trial. Surg Endosc 30, 1156–1163 (2016). https://doi.org/10.1007/s00464-015-4320-9

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