Effects of a laboratory-based skills curriculum on laparoscopic proficiency: a randomized trial.
OBJECTIVE
The purpose of this study was to determine the effect and validity of an intensive laboratory-based laparoscopic skills training curriculum on operative proficiency in obstetrics and gynecology residents.


METHODS
This was a prospective, randomized, block-design trial of postgraduate year 3 and 4 residents. The following study schedule was used: week 1 (pre-randomization) included an orientation to study objectives, the administration of a laparoscopic experience questionnaire, timed video-laparoscopic drills (5 total), and the performance of a video-recorded laparoscopic partial salpingectomy; during weeks 2 and 3, the skills group residents repeated the laparoscopic drills 30 minutes daily for 10 days, and the control group residents had no formal practice sessions; during week 4, the week 1 evaluation was repeated. Operative proficiency was quantified by the Global Skills Assessment Tool through blinded, independent scoring of videotapes.


RESULTS
Twenty-six residents (skills group, 12; control group, 14) consented to the trial. Patient-related issues excluded 8 residents (30%). At week 1, no significant differences existed in previous laparoscopic experience, timed video skills, or resident operative proficiency (Global Skills Assessment Tool score) between cohorts. At week 4, both groups significantly improved their timed drill test scores. The percent reduction in time from baseline was of greater magnitude in the skills group versus control group (51% vs 18%,P <.0001). Laparoscopic performance also improved in both cohorts (P =.002). However, only the skills group demonstrated significant intra-cohort improvement from baseline (mean, 4.9 points; P =.015; 95% CI, 1-7.5).


CONCLUSIONS
A core curriculum of intensive video laparoscopic skills training improves not only technical but also operative performance among postgraduate year 3 and 4 residents.
Coleman
Robert L
RL
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Texas, Southwestern Medical Center, Dallas, USA.
Muller
Carolyn Y
CY
D002983:Clinical Competence; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D013513:Obstetric Surgical Procedures / Q000193:education*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014741:Video Recording