Pretraining on Southwestern stations decreases training time and cost for proficiency-based fundamentals of laparoscopic surgery training.
BACKGROUND
We previously reported a proficiency-based Fundamentals of Laparoscopic Surgery (FLS) curriculum that uniformly resulted in passing the technical skills certification criteria. We hypothesized that pretraining using the Southwestern (SW) videotrainer stations would decrease costs and training time and maintain benefits.


METHODS
Group I (2nd-year medical student, n = 10) underwent FLS pretesting (Pretest 1), SW station proficiency-based training, repeat FLS testing (Pretest 2), FLS proficiency-based training, and final FLS testing (Posttest). These data were compared with a historic control, group II (2nd-year medical student, n = 10), which underwent FLS pretesting (Pretest 1), proficiency-based training, and final FLS testing (Posttest).


RESULTS
During training, group I achieved proficiency (85.4 + or - 26.2 repetitions) for all SW tasks. For both groups, proficiency was achieved for 96% of the FLS tasks, with substantial differences detected for group I and group II repetitions (100.5 + or - 15.9 versus 114 + or - 25.5) and training time (6.0 + or - 1.5 versus 9.2 + or - 2.2 hours), respectively. Per-person material costs were considerably different for groups I and II ($827 + or - 116 versus $1,108 + or - 393). Group I demonstrated significant improvement from Pretest 1 (149 + or - 39; 0% FLS pass rate) to Pretest 2 (293 + or - 83; p < 0.001; 60% FLS pass rate), and to Posttest (444 + or - 60; p < 0.001; 100% FLS pass rate). Group II demonstrated significant improvement from Pretest 1 (158 + or - 78; 0% FLS pass rate) to Posttest (469.7 + or - 12.0; p < 0.001; 100% FLS pass rate).


CONCLUSIONS
Pretraining on SW stations decreases training time for FLS skill acquisition and maintains educational benefits. This strategy decreases costs associated with using consumable materials for training.
Southwestern Center for Minimally Invasive Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Madelyn E
ME
Rosenthal
Antonio O
AO
Castellvi
Mouza T
MT
Goova
Lisa A
LA
Hollett
Jarrod
J
Dale
Daniel J
DJ
Scott
D002983:Clinical Competence; D003162:Competency-Based Education / Q000191:economics* / Q000379:methods*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000191:economics*; D003363:Cost Control; D003479:Curriculum / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D010535:Laparoscopy; D008297:Male; D011597:Psychomotor Performance; D011795:Surveys and Questionnaires; D013781:Texas; D013997:Time Factors; D014481:United States