A simulation-based curriculum can be used to teach open intestinal anastomosis.
BACKGROUND
Simulation is a technique commonly used to teach technical skills such as those necessary in laparoscopic surgery. Curricula with objective, validated metrics rating performance are widely used. Simulations to develop and assess skills necessary for open surgical procedures are less common. We hypothesized that a curriculum designed to teach the skills necessary to perform open laparotomy and bowel anastomosis would result in improved knowledge of the procedure steps, increased technical skills, and improved confidence in novice surgeons.


METHODS
A simulation-based curriculum designed to teach open laparotomy and bowel anastomosis was developed. Eleven surgical interns participated in the 6-wk curriculum. Written surveys regarding confidence in the knowledge and ability to perform these procedures were administered before and after the curriculum. Videos of the first six subjects were created on the first and final repetition of the simulation. An Objective Assessment of Technical Skills (OSATS) instrument was used to evaluate each video by two independent, blinded reviewers.


RESULTS
Subjects demonstrated significantly improved OSATS scores for skills and knowledge in seven of nine domains assessed upon completion of the curriculum. Subject confidence in laparotomy and bowel anastomosis skills improved significantly.


CONCLUSIONS
A structured, simulation-based curriculum designed to teach laparotomy and hand-sewn bowel anastomosis skills is effective and increases participant confidence. Further study is required to determine whether simulation results in improved performance in the operating room.
Olson
Terrah Paul
TP
Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA.
Becker
Yolanda Tai
YT
McDonald
Robert
R
Gould
Jon
J
D000714:Anastomosis, Surgical / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation / Q000639:trends*; D003479:Curriculum / Q000639:trends*; D013505:Digestive System Surgical Procedures / Q000193:education*; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D007396:Internship and Residency; D007422:Intestines / Q000601:surgery*; D010535:Laparoscopy / Q000193:education*; D013647:Task Performance and Analysis