title: A structured four-step curriculum in basic laparoscopy: development and validation.
abstract: OBJECTIVE
  The objective of this study was to develop a four-step curriculum in basic laparoscopy consisting of validated modules integrating a cognitive component, a practical component and a procedural component.
  
  
  METHODS
  A four-step curriculum was developed. The methodology was different for each step. Step 1: A 1-day course in basic laparoscopy developed on the background of a regional needs analysis. Step 2: A multiple-choice test, developed and validated through interviews with experts in laparoscopy and subsequently through a Delphi audit involving regional chief physicians. Step 3: A procedural training task (a salpingectomy) on a validated virtual reality simulator. Step 4: An operation on a patient (a salpingectomy) with following formative assessment based on a validated assessment scale.
  
  
  METHODS
  University hospital, Copenhagen, Denmark.
  
  
  METHODS
  Fifty-two first-year residents in obstetrics and gynecology from 2009 to 2011.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Completion rate.
  
  
  RESULTS
  All participants completed step 1 and improved post-course test scores compared with pre-course test scores, p = 0.001. Step 2 was completed by 75% (37/52); all improved test scores after 6 months, p = 0.001. Step 3 was completed by 75%. Participants used 238 min (range 75-599) and 38 repetitions (range 8-99) to reach proficiency level on a virtual reality simulator. Step 4 was completed by 55%. There was no correlation between test scores and simulator training time. Protected training time was correlated with increasing completion rate.
  
  
  CONCLUSIONS
  A four-step curriculum in basic laparoscopy is applicable in residency training. Protected training time correlated with increasing completion rate.
authors.affiliation: Department of Obstetrics and Gynecology, Juliane Marie Center, Center for Children, Women and Reproduction, Rigshospitalet University Hospital, Copenhagen, Denmark.
authors.forename: Jeanett
authors.initials: J
authors.lastname: Strandbygaard
authors.forename: Flemming
authors.initials: F
authors.lastname: Bjerrum
authors.forename: Mathilde
authors.initials: M
authors.lastname: Maagaard
authors.forename: Christian
authors.initials: C
authors.lastname: Rifbjerg Larsen
authors.forename: Bent
authors.initials: B
authors.lastname: Ottesen
authors.forename: Jette L
authors.initials: JL
authors.lastname: Sorensen
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods; D003479:Curriculum / Q000592:standards / Q000639:trends; D003718:Denmark; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards; D010535:Laparoscopy / Q000193:education*; D008297:Male; D058994:Salpingectomy / Q000193:education / Q000592:standards
keywords: Laparoscopy; assessment; curriculum; multiple-choice test; virtual reality simulation