title: Development of a standardized training course for laparoscopic procedures using Delphi methodology.
abstract: BACKGROUND
  Content, evaluation, and certification of laparoscopic skills and procedure training lack uniformity among different hospitals in The Netherlands. Within the process of developing a new regional laparoscopic training curriculum, a uniform and transferrable curriculum was constructed for a series of laparoscopic procedures. The aim of this study was to determine regional expert consensus regarding the key steps for laparoscopic appendectomy and cholecystectomy using Delphi methodology.
  
  
  METHODS
  Lists of suggested key steps for laparoscopic appendectomy and cholecystectomy were created using surgical textbooks, available guidelines, and local practice. A total of 22 experts, working for teaching hospitals throughout the region, were asked to rate the suggested key steps for both procedures on a Likert scale from 1-5. Consensus was reached with Crohnbach's α ≥ 0.90.
  
  
  RESULTS
  Of the 22 experts, 21 completed and returned the survey (95%). Data analysis already showed consensus after the first round of Delphi on the key steps for laparoscopic appendectomy (Crohnbach's α = 0.92) and laparoscopic cholecystectomy (Crohnbach's α = 0.90). After the second round, 15 proposed key steps for laparoscopic appendectomy and 30 proposed key steps for laparoscopic cholecystectomy were rated as important (≥4 by at least 80% of the expert panel). These key steps were used for the further development of the training curriculum.
  
  
  CONCLUSIONS
  By using the Delphi methodology, regional consensus was reached on the key steps for laparoscopic appendectomy and cholecystectomy. These key steps are going to be used for standardized training and evaluation purposes in a new regional laparoscopic curriculum.
authors.affiliation: Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands; Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: msbethlehem@hotmail.com.
authors.forename: Martijn S
authors.initials: MS
authors.lastname: Bethlehem
authors.affiliation: Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Kelvin H
authors.initials: KH
authors.lastname: Kramp
authors.affiliation: Leeuwarden Institute for Minimal Invasive Surgery, Leeuwarden, The Netherlands; Department of Surgery, Hospital Group Twente (ZGT), Almelo, The Netherlands.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: van Det
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Post Graduate School of Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Henk O
authors.initials: HO
authors.lastname: ten Cate Hoedemaker
authors.affiliation: Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Nicolaas J G M
authors.initials: NJ
authors.lastname: Veeger
authors.affiliation: Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands; Leeuwarden Institute for Minimal Invasive Surgery, Leeuwarden, The Netherlands; Post Graduate School of Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Jean Pierre E N
authors.initials: JP
authors.lastname: Pierie
mesh_terms: D001062:Appendectomy / Q000193:education*; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D032921:Consensus; D003479:Curriculum; D003697:Delphi Technique; D006801:Humans; D007396:Internship and Residency; D009426:Netherlands; D016730:Program Development; D011795:Surveys and Questionnaires; D014741:Video Recording
keywords: Delphi technique; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; appendectomy; cholecystectomy; laparoscopy; training