title: Validation of a structured intensive laparoscopic course for basic and advanced gynecologic skills training.
abstract: OBJECTIVE
  To describe and validate a gynecologic laparoscopic-surgery training model.
  
  
  METHODS
  The present prospective observational study was conducted at the Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Spain, between January 2011 and June 2013. Novice gynecologists attended a 3-day course including simulation and animal training. Participants' were assessed before and after training using a virtual reality simulator; during training, gynecologists were timed and assessed using an Objective and Structured Assessment of Technical Skills score. The virtual reality simulator-assessed skills were eye-hand coordination, hand-hand coordination, and transference of objects. Participants were asked to rate various elements of the training program using a five-point scale.
  
  
  RESULTS
  The study enrolled 21 gynecologists. Participants performed all tasks faster (P<0.001), using fewer movements (P<0.05 for left and right instruments), after receiving training. During participants' final animal and simulator training sessions, completion times were reduced (P<0.001) and assessment scores (P<0.001) increased for all techniques and tasks. Participants considered suturing to be the most useful aspect of the basic-skills training (4.95±0.22); animal training received a higher rating than simulator training for practicing new techniques (4.81±0.40 vs 4.05±0.86) and maintaining skills (4.76±0.54 vs 3.95±0.97).
  
  
  CONCLUSIONS
  Combining proficiency-based physical simulation and animal training models under expert guidance is an efficient model for improving basic and advanced laparoscopic skills. Suturing and animal models were the preferred training components.
authors: Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Spain. Electronic address: senciso@ccmijesususon.com.
authors: Silvia
authors: S
authors: Enciso
authors: Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Spain.
authors: Idoia
authors: I
authors: Díaz-Güemes
authors: Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain.
authors: Tirso
authors: T
authors: Pérez-Medina
authors: La Paz University Hospital, Madrid, Spain.
authors: Ignacio
authors: I
authors: Zapardiel
authors: La Paz University Hospital, Madrid, Spain.
authors: Javier
authors: J
authors: de Santiago
authors: Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Spain.
authors: Jesús
authors: J
authors: Usón
authors: Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Spain.
authors: Francisco M
authors: FM
authors: Sánchez-Margallo
mesh_terms: D000328:Adult; D000818:Animals; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000193:education*; D006176:Gynecology / Q000193:education*; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D023421:Models, Animal; D011446:Prospective Studies; D000066908:Simulation Training / Q000592:standards*; D013030:Spain; D011795:Surveys and Questionnaires
keywords: Assessment; Laparoscopy; Skills; Training; Virtual reality simulation