A prospective evaluation of a simulator-based laparoscopic training program for gynecology residents.
BACKGROUND
To determine prospectively if simulator-based laparoscopic training could improve laparoscopic skills of gynecology residents.


METHODS
Twenty-six gynecology residents were enrolled in a laparoscopy training curriculum involving didactics, self-paced learning modules, and graded simulator-based laparoscopic training modules. Six simulator tasks were developed to introduce incremental levels of difficulty. Residents were tested on bead/peg manipulation, passing of a specially designed "key," cutting of lines and circles on a two-layer latex glove, and laparoscopic suturing followed by both intra- and extracorporeal knot tying. Times for each task and penalties for errors were assessed at baseline and after 3 months of training.


RESULTS
Twenty-six residents completed initial baseline and 3-month evaluations. Average summary time (including 30-seconds penalties for each error) at baseline was 64 minutes and 36 minutes at 3-month evaluation (p < 0.001). For PGY1 baseline summary times averaged 83 minutes compared with 50 minutes at 3 months (p = 0.006). For PGY4 baseline summary times averaged 49 minutes compared with 28 minutes at 3 months (p = 0.05). All individual tasks demonstrated substantial improvement (p < 0.001) from baseline to 3-month evaluation. Baseline summary scores demonstrated correlation between PGY training year and overall score (p < 0.001) consistent with earlier ability and training. Three-month scores demonstrated equalization of skill level across PGY2 through PGY4.


CONCLUSIONS
A dedicated simulator-based laparoscopic training curriculum has the ability to improve basic laparoscopic skills in a gynecologic residency, as measured by timed and scored simulator tasks. Construct validity was demonstrated by measuring substantial improvement in performance with increasing residency training, and with practice.
Kirby
Tyler O
TO
West Coast Gynecologic Oncology, Clearwater, FL, USA.
Numnum
T Michael
TM
Kilgore
Larry C
LC
Straughn
J Michael
JM
D002983:Clinical Competence; D003162:Competency-Based Education / Q000458:organization & administration*; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D017145:Models, Educational; D009048:Motor Skills; D009774:Obstetrics / Q000193:education*; D011214:Practice, Psychological; D011446:Prospective Studies; D015203:Reproducibility of Results