title: Design, delivery, and validation of a trainer curriculum for the national laparoscopic colorectal training program in England.
abstract: OBJECTIVE
  To validate the delivery and efficacy of the national laparoscopic colorectal surgery "training the trainer" (Lapco TT) curriculum.
  
  
  BACKGROUND
  The National Training Programme in Laparoscopic Colorectal Surgery designed the Lapco TT curriculum to improve, standardize, and benchmark the quality of training. Evidence for such courses rarely extends beyond subjective feedback.
  
  
  METHODS
  The Lapco TT curriculum tailors key teaching skills for laparoscopic colorectal surgery: training structure, skills deconstruction, trainer intervention, and performance enhancing feedback. Ten Lapco TT courses were delivered to 65 national Lapco trainers since 2010. The course was validated at Kirkpatrick's 4 levels of evaluation: (i) pre- and post-course interviews reflecting initial reaction; (ii) training quality assessment on simulated scenarios using the Structured Training Trainer Assessment Report (STTAR) tool; (iii) follow-up interviews at 4 to 6 months; and (iv) delegate performance ratings, by their trainees, using the mini-STTAR and the delegates' trainees learning curves before and after the course.
  
  
  RESULTS
  There were significant improvements in training in the post-course simulated scenario, especially in the "set" (P < 0.001). Delegates described improved framework and structure in their native training environment, which aided difficult training situations. Findings mirrored in performance ratings by their trainees: overall (4.37 vs 4.46, P = 0.040), agreed learning points (3.65 vs 4.00, P = 0.042), encouraged self-reflection (3.67 vs 3.94, P = 0.046), and encouraged team awareness (3.53 vs 4.05, P = 0.045). The learning curve of delegates' trainees improved after the course.
  
  
  CONCLUSIONS
  The Lapco TT curriculum improved training performance in the short- and long-term, provided a structured training framework, and enhanced the learning curve of delegates' trainees.
authors.affiliation: *Department of Surgery and Cancer, Imperial College, London, United Kingdom †Department of Surgery, Princess Alexandra Hospital, Harlow, United Kingdom ‡John Goligher Colorectal Unit, The Leeds Teaching Hospitals, Leeds, United Kingdom §National Training Programme for Laparoscopic Surgery, Plymouth, United Kingdom ¶Department of Gastroenterology, Gloucestershire Hospitals, Gloucester, United Kingdom ∥Wolfson Unit for Endoscopy, St Mark's Hospital, London, United Kingdom **Colorectal Unit, Derriford Hospital, Plymouth, United Kingdom ††Department of Surgery, Yeovil District Hospital Foundation Trust, Yeovil, United Kingdom.
authors.forename: Hugh
authors.initials: H
authors.lastname: Mackenzie
authors.forename: Tamzin
authors.initials: T
authors.lastname: Cuming
authors.forename: Danilo
authors.initials: D
authors.lastname: Miskovic
authors.forename: Susannah M
authors.initials: SM
authors.lastname: Wyles
authors.forename: Laura
authors.initials: L
authors.lastname: Langsford
authors.forename: John
authors.initials: J
authors.lastname: Anderson
authors.forename: Siwan
authors.initials: S
authors.lastname: Thomas-Gibson
authors.forename: Roland
authors.initials: R
authors.lastname: Valori
authors.forename: George B
authors.initials: GB
authors.lastname: Hanna
authors.forename: Mark G
authors.initials: MG
authors.lastname: Coleman
authors.forename: Nader
authors.initials: N
authors.lastname: Francis
mesh_terms: D002983:Clinical Competence; D003107:Colorectal Surgery / Q000193:education*; D003479:Curriculum; D004739:England; D005178:Faculty / Q000592:standards*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D008297:Male; D008953:Models, Anatomic; D016544:Patient Simulation; D013663:Teaching / Q000592:standards*