title: Early analysis of laparoscopic common bile duct exploration simulation.
abstract: BACKGROUND
  We developed a laparoscopic common bile duct exploration (LCBDE) simulation course for resident surgeons (RS) and practicing surgeons (PS). We hypothesized that course completion would provide LCBDE procedural skills and increase procedure utilization.
  
  
  METHODS
  RS and PS were prospectively enrolled. Pre- and post-course ability were assessed with written examinations and LCBDE simulations. PS completed pre-course, post-course, and 1-year follow-up surveys (5-point Likert-type scale).
  
  
  RESULTS
  17 RS and 8 PS were enrolled. Median written test scores improved (70.0%-80.0%, p < 0.001) and median LCBDE simulation times (seconds) improved (585-314, p = 0.001) among all participants. Comparing RS and PS, median written assessment scores pre-course (70% vs 72.5%, p = 0.953) and post-course (77.5% vs 80.0%, p = 0.198) were not significantly different. Simulation completion times (seconds) improved similarly from pre-course (608.0 vs 521.5, p = 0.885) to post-course (314.0 vs 373.0, p = 0.287) between groups. PS comfort with LCBDE improved (2-4, p = 0.03). All PS reported LCBDE utilization 1 year post-course.
  
  
  CONCLUSIONS
  The LCBDE course is appropriate for RS and PS. PS also reported increased comfort with LCBDE and procedure utilization.
authors.affiliation: Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA; Oregon Health & Science University, Department of Surgery, Portland, OR, USA. Electronic address: pk98@dm.duke.edu.
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Kemp Bohan
authors.affiliation: Oregon Health & Science University, Department of Surgery, Portland, OR, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Connelly
authors.affiliation: Oregon Health & Science University, Department of Surgery, Portland, OR, USA.
authors.forename: Jeff
authors.initials: J
authors.lastname: Crawford
authors.affiliation: Kaiser Permanente, Oregon/Washington Region, Department of General Surgery, Sunnyside Medical Center, Clackamas, OR, USA.
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Bronson
authors.affiliation: Oregon Health & Science University, Department of Surgery, Portland, OR, USA.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Schreiber
authors.affiliation: Kaiser Permanente, Oregon/Washington Region, Department of General Surgery, Sunnyside Medical Center, Clackamas, OR, USA.
authors.forename: Chris W
authors.initials: CW
authors.lastname: Lucius
authors.affiliation: Oregon Health & Science University, Department of Surgery, Portland, OR, USA.
authors.forename: John G
authors.initials: JG
authors.lastname: Hunter
authors.affiliation: Oregon Health & Science University, Department of Surgery, Portland, OR, USA.
authors.forename: Laszlo N
authors.initials: LN
authors.lastname: Kiraly
authors.affiliation: Oregon Health & Science University, Department of Surgery, Portland, OR, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Ham
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000193:education* / Q000379:methods / Q000706:statistics & numerical data; D002983:Clinical Competence; D003135:Common Bile Duct / Q000601:surgery*; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000379:methods*; D005500:Follow-Up Studies; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D009922:Oregon; D011446:Prospective Studies; D000066908:Simulation Training / Q000379:methods*