Objective Evaluation of the Effects of Deployment on Laparoscopic Skills: The Simulation and Deployment Laparoscopic Skills Study.
To assess the effects of deployment on basic laparoscopic skills of general surgeons and obstetrics/gynecology (OB/GYN) physicians.



This was a prospective 10-site study. Active duty Army OB/GYN and general surgery physicians scheduled to deploy were invited to participate. Before deployment, they performed fundamentals of laparoscopic surgery (FLS) tasks and specialty-specific procedures on a virtual reality laparoscopic simulator. Upon returning, physicians repeated the same evaluations. Questions about perceived comfort with laparoscopic procedures were asked before and after deployment. Statistical analysis included paired t tests for continuous variables and nonparametric for ordinal data with a p value of <0.05 considered significant.



121 deploying providers were invited to participate; 35 agreed and 29 completed the predeployment skills assessment. After deployment, 15 providers had postassessment evaluation data collected, and their results were used for analysis. Though physicians reported a decrease in their perception of preparedness for advanced laparoscopic procedures and complications, there was no decrement in their performance of FLS tasks or the basic laparoscopic procedures.



Time away from regular clinical practice during deployments did not significantly affect surgeons' performance as measured by a virtual reality laparoscopic simulator. Additional study on effects on advanced procedures should be considered.
Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20889-5611.
Shad H
SH
Deering
Andersen Simulation Center, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431.
Laurie B
LB
Kavanagh
Department of OB/GYN, Madigan Army Medical Center, Tacoma, WA 98431.
Michael K
MK
Chinn
Department of Minimally Invasive and Bariatric Surgery, Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650.
Yong
Y
Choi
Department of General Surgery, Madigan Army Medical Center, Tacoma, WA 98431.
Robert M
RM
Rush
Andersen Simulation Center, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431.
Imad
I
Haque
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D015331:Cohort Studies; D003198:Computer Simulation; D013502:General Surgery / Q000592:standards; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D008875:Middle Aged; D008887:Military Medicine / Q000592:standards; D009048:Motor Skills; D009774:Obstetrics / Q000592:standards; D011446:Prospective Studies; D000078329:Workforce