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Structured simulation improves learning of the Fundamental Use of Surgical Energy™ curriculum: a multicenter randomized controlled trial

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Abstract

Background

Energy devices can result in devastating complications to patients. Yet, they remain poorly understood by trainees and surgeons. A single-institution pilot study suggested that structured simulation improves knowledge of the safe use of electrosurgery (ES) among trainees (Madani et al. in Surg Endosc 28(10):2772–2782, 2014). The purpose of this study was to estimate the extent to which the addition of this structured bench-top simulation improves ES knowledge across multiple surgical training programs.

Methods

Trainees from 11 residency programs in Canada, the USA and UK participated in a 1-h didactic ES course, based on SAGES’ Fundamental Use of Surgical Energy™ (FUSE) curriculum. They were then randomized to 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). Pre- and post-curriculum (immediately and 3 months after) knowledge of the safe use of ES was assessed using separate examinations. Data are expressed as mean (SD) and N (%), *p < 0.05.

Results

A total of 289 (145 control; 144 Sim) trainees participated, with 186 (96 control; 90 Sim) completing the 3-month assessment. Baseline characteristics were similar between the two groups. Total score on the examination improved from 46 % (10) to 84 % (10)* for the entire cohort, with higher post-curriculum scores in the Sim group compared with controls [86 % (9) vs. 83 % (10)*]. All scores declined after 3 months, but remained higher in the Sim group [72 % (18) vs. 64 % (15)*]. Independent predictors of 3-month score included pre-curriculum score and participation in a goal-directed simulation.

Conclusions

This multi-institutional study confirms that a 2-h curriculum based on the FUSE program improves surgical trainees’ knowledge in the safe use of ES devices across training programs with various geographic locations and resident volumes. The addition of a structured interactive bench-top simulation component further improved learning.

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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. This study was funded by a SAGES Research Grant (#188). A.M. is supported by the Quebec Health Science Research Scholarship (FRQ-S) and the McGill Surgeon-Scientist Program. The Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation is supported by an unrestricted educational grant from Covidien©.

Disclosures

Dr. Liane Feldman received an unrestricted educational grant from ConMed. Drs. Amin Madani, Yusuke Watanabe, Nicole Townsend, Philip H. Pucher, Thomas N. Robinson, Patricia E. Egerszegi, Jaisa Olasky, Sharon L. Bachman, Chan W. Park, Nalin Amin, David T. Tang, Erika Haase, Davide Bardana, Daniel B. Jones, Melina Vassiliou and Gerald M. Fried MD have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, 1650 Cedar Avenue, Rm L9-309, Montreal, QC, H3G 1A4, Canada

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

  2. Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Nicole Townsend & Thomas N. Robinson

  3. Department of Surgery and Cancer, Imperial College London, London, UK

    Philip H. Pucher

  4. Department of Surgery, Université de Montréal, Montreal, QC, Canada

    Patricia E. Egerszegi

  5. Department of Surgery, Harvard University, Boston, MA, USA

    Jaisa Olasky & Daniel B. Jones

  6. Inova Medical Group – Surgical Services, Falls Church, VA, USA

    Sharon L. Bachman

  7. Department of Surgery, Duke University, Durham, NC, USA

    Chan W. Park

  8. Department of Surgery, McMaster University, Hamilton, ON, Canada

    Nalin Amin

  9. Department of Surgery, Dalhousie University, Halifax, NS, Canada

    David T. Tang

  10. Department of Surgery, University of Alberta, Edmonton, AB, Canada

    Erika Haase

  11. Department of Surgery, Queen’s University, Kingston, ON, Canada

    Davide Bardana

Authors
  1. Amin Madani
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  2. Yusuke Watanabe
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  3. Nicole Townsend
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  4. Philip H. Pucher
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  5. Thomas N. Robinson
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  6. Patricia E. Egerszegi
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  7. Jaisa Olasky
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  8. Sharon L. Bachman
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  9. Chan W. Park
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  10. Nalin Amin
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  11. David T. Tang
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  12. Erika Haase
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  13. Davide Bardana
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  14. Daniel B. Jones
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  15. Melina Vassiliou
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  16. Gerald M. Fried
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  17. Liane S. Feldman
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Corresponding author

Correspondence to Amin Madani.

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Madani, A., Watanabe, Y., Townsend, N. et al. Structured simulation improves learning of the Fundamental Use of Surgical Energy™ curriculum: a multicenter randomized controlled trial. Surg Endosc 30, 684–691 (2016). https://doi.org/10.1007/s00464-015-4260-4

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  • DOI: https://doi.org/10.1007/s00464-015-4260-4

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