Optimizing Training Efficiency for Fundamentals of Laparoscopic Surgery Skills: Preliminary Results Using a Novel Learning Curriculum
Bedway, Andrea R.
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Fundamentals of Laparoscopic Surgery (FLS) is a cognitive and technical skills program designed to teach and evaluate the knowledge, judgment, and skills fundamental to laparoscopic surgery. To date there has been no training curriculum created to advise individuals on how to improve their performance on the manuals skills aspect of the program. The objective of this study was to develop a training curriculum for graduate medical education programs to use that is specifically designed to help residents improve upon the skill steps necessary to complete the FLS manual skills task. Laparoscopic skills of 20 first-year surgical residents at Wayne State University were evaluated for four skills tasks with faculty proctored pre-testing. Thereafter, residents were tested weekly for four weeks. The residents were encouraged to additionally practice tasks individually, but participation was voluntary. All 19 residents who completed the program improved their individual FLS task completion times for each of the four tasks. As a group, the mean task completion times for each task decreased every week during the four week training period. The 19 residents was composed of seven individuals with previous experience and twelve with no previous experience in FLS; both groups showed improvements in FLS tasks to proficiency level standards. Performance in these residents was compared to first-year residents in 2008 that did not participate in any training program, but practiced over a 16-week period this program. The 2009 group who underwent this training curriculum made greater improvements in a fourth of the amount of training time. This novel laparoscopic training program was beneficial to first-year surgical residents with and without prior experience with the FLS manual skills tasks. This curriculum allowed residents to achieve proficiency with fewer repetitions, less cost, and at an earlier time in training when compared to the results from a proficiency-based curriculum (Scott, et.al, 2007). We suggest the use of this curriculum for the basic laparoscopic training of surgical residents.