title: Immediate impact of an intensive one-week laparoscopy training program on laparoscopic skills among postgraduate urologists.
abstract: BACKGROUND
  Laparoscopic techniques are difficult to master, especially for surgeons who did not receive such training during residency. To help urologists master challenging laparoscopic skills, a unique 5-day mini-residency (M-R) program was established at the University of California, Irvine. The first 101 participants in this program were evaluated on their laparoscopic skills acquisition at the end of the 5-day experience.
  
  
  METHODS
  Two urologists are accepted per week into 1 of 4 training modules: (1) ureteroscopy/percutaneous renal access; (2) laparoscopic ablative renal surgery; (3) laparoscopic reconstructive renal surgery; and (4) robot-assisted prostatectomy. The program consists of didactic lectures, pelvic trainer and virtual reality simulator practice, animal and cadaver laboratory sessions, and observation or participation in human surgeries. Skills testing (ST) simulating open, laparoscopic, and robotic surgery is assessed in all of the M-R participants on training days 1 and 5. Tests include ring transfer, suture threading, cutting, and suturing. Performance is evaluated by an experienced observer using the Objective Structured Assessment of Technical Skill (OSATS) scoring system. Statistical methods used include the paired sample t test and analysis of variance at a confidence level of P<or=0.05.
  
  
  RESULTS
  Between July 2003 and June 2005, 101 urologists participated in the M-R program. The mean participant age was 47 years (range, 31 to 70). The open surgical format had the highest ST scores followed by the robotic and then the laparoscopic formats. The final ST scores were significantly higher than the initial ST scores (P<0.05) for the laparoscopic (58 vs. 52) and the robotic (114 vs. 95) formats. Open surgical ST scores did not change significantly during the training program (191 vs. 194) (P=0.17).
  
  
  CONCLUSIONS
  Laparoscopic and robotic ST scores, but not open ST scores, improved significantly during this intensive 5-day M-R program. The robotic ST scores demonstrated greater improvement than did the laparoscopic ST scores, suggesting that the transfer of laparoscopic skills may be improved using the robotic interface.
authors.affiliation: Department of Urology, University of California, Irvine, Orange, California 92868, USA.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Vlaovic
authors.forename: Eric R
authors.initials: ER
authors.lastname: Sargent
authors.forename: John R
authors.initials: JR
authors.lastname: Boker
authors.forename: Federico A
authors.initials: FA
authors.lastname: Corica
authors.forename: David S
authors.initials: DS
authors.lastname: Chou
authors.forename: Corollos S
authors.initials: CS
authors.lastname: Abdelshehid
authors.forename: Shannon M
authors.initials: SM
authors.lastname: White
authors.forename: Leandro G
authors.initials: LG
authors.lastname: Sala
authors.forename: Frank
authors.initials: F
authors.lastname: Chu
authors.forename: Todd
authors.initials: T
authors.lastname: Le
authors.forename: Ralph V
authors.initials: RV
authors.lastname: Clayman
authors.forename: Elspeth M
authors.initials: EM
authors.lastname: McDougall
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003479:Curriculum; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012371:Robotics; D013536:Suture Techniques / Q000193:education; D013663:Teaching / Q000379:methods; D014572:Urology / Q000193:education*