Pilot study of new training model for laparoscopic surgery

Abstract

The aim of this study was to evaluate whether an assessment exercise performed on a laparoscopic trainer model reliably reflects previous laparoscopic experience and can therefore be used to accurately assess laparoscopic skills in surgical trainees. Subjects were recruited from a cross-section of surgical trainees and students at the Great Ormond Street Hospital for Children and the Institute of Child Health. Subjects were required to complete a baseline laparoscopic surgical skills questionnaire and an exercise on a new laparoscopic trainer model. Nine subjects completed both the baseline questionnaire and the exercise. These subjects exhibited a wide range of previous experience in laparoscopic surgery. Subjects with higher self-assessment scores had the lowest exercise scores (i.e. better scores; P=0.003). Furthermore, the exercise score was strongly negatively correlated with the baseline number of training modalities received (P=0.007) and the laparoscopic experience score (P=0.027). The assessment exercise on a novel laparoscopic trainer was capable of differentiating between subjects with little laparoscopic experience and those with more extensive previous laparoscopic training. The correlation between the exercise score and measured baseline variables suggests that the scoring system used in this model is sensitive and specific to measuring skills relevant to laparoscopic surgery.

Appendix: Laparoscopic experience self-assessment questionnaire

Question
1	Gender (male/female)
2	Age (20–30; 30–40; 40–65 years)
3	Dominant hand (right/left)
4	Position (consultant; specialist registrar; research fellow; SHO surgery; SHO medicine; medical student)
5	How many years of postgraduate surgical training have you completed? (1–3; 3–8; (8 years)
6	How many laparoscopic surgeries have you observed, assisted, and performed? (none [0 points]; (10 [1 point]; 10–50 [2 points]; (50 [3 points]; max. score 9 points)
7	Have you worked with a robotic telescopic control AESOP? (no; 1–10; >10)a
8	Which forms of laparoscopic training have you received? (none [0 points]; on-the-job [1 points]; bench trainer [1 points]; laparoscopic course [1 points]; score 0–3)
9	How many laparoscopic courses have you completed? (1 course = 1 point)
10	What modules did these courses include?a (didactic sessions, video or live operating demonstrations, bench-trainer, training on animals, or virtual reality training; 1 point each)
11	Please evaluate your competency in laparoscopic motor skills? (inserting the primary trocar, inserting the secondary trocar, dissection of tissue, electrocoagulation, needle pick-up, rotation of the needle, suture placement, intracorporeal knot tying, suture cutting, clip placement, ambidextrous motor skills, and hand–eye coordination; scale from 0 to 3 (0= skills not performed; 1= beginner; 2= intermediate; and 3= advanced)
12	Do you feel competent about your motor skills in laparoscopic surgery? (scale 1–5; 1= not competent and 5= competent)
13	Are you satisfied with laparoscopic training at GOSH?a

1. ^aPlease note: this data has not been presented in this paper