title: French intensive training course in laparoscopic surgery (HUGOFirst) on live porcine models: Validation of a performance assessment scale and residents' satisfaction in a prospective study.
abstract: BACKGROUND
  Simulation as a method for practical teaching of surgical residents requires objective evaluation in order to measure the student's acquisition of knowledge and skills. The objectives of this article are to publish our evaluation and validation grids and also the measure of student satisfaction.
  
  
  METHODS
  A teaching platform based on practical exercises with a porcine model was created in 2009 at seven French University Hospitals. Three times a year, 31 Diplôme d'Études Spécialisées Complémentaires (DESC) surgical residents underwent timed assessment of the performance of five surgical tasks: trocar insertion (trocars) testing the convergence of instruments (convergence), intra-corporeal knot tying (knots), running of the small intestine to find a lesion (exploration), and performance of a running suture closure of the peritoneum (closure). Two experts evaluated performances prospectively on grid score sheets specifically designed and validated for these exercises. We measured time, scores on a rating scale, and the interest and satisfaction of the residents.
  
  
  RESULTS
  Data for 31 residents between May 2011 and March 2012 were analyzed. Rating scales were statistically validated and correlated (Kappa correlation coefficient K>0.69) for each task. The performance times of the most experienced residents decreased significantly for all tasks except for small bowel exploration (P=0.2). After four sessions, times were significantly improved with better quality (fewer errors and higher average scores [>88%]), regardless of the residents' experience. Of the participants, 92% were satisfied, 86% thought that the sessions improved their technical skills and 74% thought it had a favorable impact on their clinical practice.
  
  
  CONCLUSIONS
  This study shows that the performance of surgical techniques can be improved through simulation, that HUFEG grids are valid, and that this teaching program is popular with surgical residents.
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Poitiers, 86000 Poitiers, France. Electronic address: marie-line.barussaud@chu-poitiers.fr.
authors.forename: M-L
authors.initials: ML
authors.lastname: Barussaud
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Poitiers, 86000 Poitiers, France.
authors.forename: B
authors.initials: B
authors.lastname: Roussel
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne, University Hospital of Nantes, 44000 Nantes, France.
authors.forename: G
authors.initials: G
authors.lastname: Meurette
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Rennes, 35000 Rennes, France.
authors.forename: L
authors.initials: L
authors.lastname: Sulpice
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Rennes, 35000 Rennes, France.
authors.forename: B
authors.initials: B
authors.lastname: Meunier
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne, University Hospital of Nantes, 44000 Nantes, France.
authors.forename: N
authors.initials: N
authors.lastname: Regenet
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Tours, 37000 Tours, France.
authors.forename: C
authors.initials: C
authors.lastname: Bourbao-Tournois
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Tours, 37000 Tours, France.
authors.forename: N
authors.initials: N
authors.lastname: Huten
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Angers, 49000 Angers, France.
authors.forename: E
authors.initials: E
authors.lastname: Lhermite
authors.affiliation: Centre René Gauducheau, 44000 Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Paineau
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Limoges, 87000 Limoges, France.
authors.forename: S
authors.initials: S
authors.lastname: Durand-Fontanier
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Brest, 29000 Brest, France.
authors.forename: J
authors.initials: J
authors.lastname: Theraux
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Poitiers, 86000 Poitiers, France.
authors.forename: M
authors.initials: M
authors.lastname: Carretier
authors.affiliation: Service de Chirurgie Digestive, University Hospital of Poitiers, 86000 Poitiers, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Faure
mesh_terms: D000328:Adult; D000818:Animals; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D005602:France; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education* / Q000592:standards; D008297:Male; D023421:Models, Animal; D010549:Personal Satisfaction; D011446:Prospective Studies; D000066908:Simulation Training / Q000379:methods*; D013552:Swine
keywords: Evaluation Grid; Laparoscopy; Performance; Porcine model; Satisfaction; Simulation; Surgical technique