title: Effectiveness of learning advanced laparoscopic skills in a brief intensive laparoscopy training program.
abstract: BACKGROUND
  Intensive training programs arose from limitations in access to simulation centers. The aim of this study is to evaluate the effect and associated factors involved in an intensive course for learning advanced laparoscopic skills, which include validated teaching techniques.
  
  
  METHODS
  General surgeons and final-year residents were analyzed after completing an intensive 5-session advanced laparoscopy course. Initial (IA) and final assessment (FA) consisted in performing a jejunojejunal anastomosis in a live porcine model, measured using objective structured assessment of technical skill (OSATS) (GRS and SRS, that is, global rating scale and specific rating scale, respectively) and operative time (OT). The 3-session training was structured in a bench model with an ex vivo bowel. For the demographic analysis, 3 groups were defined according to the presentation of relevant changes in OSATS and in OT between IA and FA: group A, no changes; group B, change in 1 variable; and group C, change in both variables.
  
  
  RESULTS
  After the course, all 114 participants presented a significant improvement in OT (37 vs 24.6min, p < 0.001) and in OSATS; global rating scale (10.5 vs 16 points; p < 0.001) and Specific Rating Scale (8.5 vs 12.7 points; p < 0.001). In the IA, 70 (61%) participants completed the jejunojejunal anastomosis and 105(92%) in the FA (p < 0.01). In the FA, 56% of participants presented relevant changes in both variables (group C). This group was significantly younger (34 vs 45 vs 40y old; p < 0.001), had fewer years of surgical experience (2 vs 9 vs 5y; p < 0.001), and had a proportionally higher concentration of residents (p = 0.01).
  
  
  CONCLUSIONS
  This intensive course is set out as a viable alternative to teach basic skills in advanced laparoscopy in a short period of time, which is ideal for surgeons with difficult access to training centers. It remains necessary to establish the participant profile for which this type of course is most beneficial.
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Richard
authors.initials: R
authors.lastname: Castillo
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Erwin
authors.initials: E
authors.lastname: Buckel
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Felipe
authors.initials: F
authors.lastname: León
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Julián
authors.initials: J
authors.lastname: Varas
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Juan
authors.initials: J
authors.lastname: Alvarado
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Achurra
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Arnold and Blema Steinberg Medical Simulation Centre, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Aggarwal
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Jarufe
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: bozauc@mac.com.
authors.forename: Camilo
authors.initials: C
authors.lastname: Boza
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000193:education*; D000818:Animals; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000193:education*; D008875:Middle Aged; D013552:Swine
keywords: Medical Knowledge; Practice-Based Learning and Improvement; Systems-Based Practice; advanced laparoscopy; laparoscopic training; simulation; training courses