• Scott W Schimpke, Brandon M Larson, Benjamin R Veenstra, Jonathan A Myers, Aleksandra Wojtowicz, and Jose M Velasco.
• Center for Clinical Skills and Simulation, Rush University Medical Center, Chicago, IL; Department of Surgery, Rush University Medical Center, Chicago, IL. Electronic address: scott_w_schimpke@rush.edu.
• J. Am. Coll. Surg. 2020 Jul 1; 231 (1): 140-148.

BackgroundGraduating surgery residents often feel unprepared to practice autonomously in the current era of surgical training. We implemented an integrated simulation curriculum to improve residents' autonomy and increase their confidence to practice independently. In this study, we chose a laparoscopic ventral hernia repair (LVHR) as our pilot operation to test proof of concept and on which we would construct our integrated curriculum.Study DesignThe curriculum included a web-based cognitive component, inanimate model simulation session with follow-up at 2 weeks and 6 months, and self-confidence questionnaires. Faculty rated each resident's procedure-specific skill by using a modified Global Operative Assessment of Laparoscopic Skills (GOALS) criteria and a task-specific checklist.ResultsThirteen junior residents, 7 senior residents, and 7 faculty surgeons completed the curriculum. Four junior residents (31%) achieved proficiency at their first session, 10 (77%) after the second session (p = 0.031), and 6 (67%) at 6 months (p ≥ 0.99). Three residents regressed and did not maintain proficiency after the second assessment. Performance (GOALS) scores improved (p = 0.0313) at week 2 and were maintained at 6 months (p = 0.5625). Required faculty direction decreased (p = 0.004), and resident confidence in completing the procedure independently improved (p < 0.004) over the 6-month curriculum.ConclusionsAssessing procedure-specific and global laparoscopic skills through a simulation-based curriculum is feasible and can be used to augment resident training. Our curriculum demonstrated improvement in proficiency and self-confidence while performing an LVHR. Additional study is needed to examine the optimal way to integrate procedure-specific simulation models into training programs.Copyright © 2020 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

15 keywords...

hide…