Simulatieonderwijs in minimaal-invasieve chirurgie

Objective

To investigate the additional value of the Advanced Suturing Course (ASC) in the basic laparoscopic skills training curriculum for residents.

Design

Prospective cohort study.

Method

Laparoscopic skills of 162 participants attending one of 17 ASCs held during the period April 2008-December 2010, were assessed before and after the training. Subjective and objective evaluation was performed using the Objective Structured Assessment of Technical Skills (OSATS) list and Motion Analysis Parameters (MAPs), recorded with the Training in Endoscopy tracking system, respectively. Confidence of participants in various laparoscopic tasks was rated using a visual analogue scale.

Results

At the end of the first course day, mean OSATS-scores were significantly higher for open and laparoscopic knot-tying tasks than before the first course day. After 6 weeks of autonomous training, these scores were unaltered. Right hand MAPs were also unaltered after this training period. Confidence of participants in completing an open or a laparoscopic knot increased significantly during the entire course, as well as confidence in completing an open or laparoscopic intestinal anastomosis.

Conclusion

Medical simulation-based skills training appears to be an efficient method to improve certain basic laparoscopic skills in a relatively short period. Regular practice, sufficient opportunities for evaluation and feedback, and skills assessment are hereby critical.

Conflict of interest: none declared. Financial support: none declared.