Allan Okrainec1, Lloyd Smith, Georges Azzie. 1. Department of Surgery, Toronto Western Hospital - University Health Network, 8th Floor, Main Pavilion, Rm 325, M5T 2S8, Toronto, ON, Canada. allan.okrainec@uhn.on.ca
Abstract
INTRODUCTION: The use of laparoscopy in resource-restricted countries has increased in recent years. Although simulation is now considered an important adjunct to operating-room-based training for learning laparoscopic skills, there is very little literature assessing the use of simulation in resource-restricted countries. The purpose of this study was to determine the feasibility and impact of a 3-day Fundamentals of Laparoscopic Surgery (FLS) course in Botswana, Africa. METHODS: A total of 20 surgeons and trainees participated in a 3-day FLS course. A pretest FLS score was obtained for each subject, followed by 2 days of practice with feedback. A final FLS posttest score was then obtained. Participants also watched the FLS instructional CD-ROM and took the written test on day 3. RESULTS: Mean posttest scores were significantly higher than pretest scores for each FLS task and for the total normalized FLS simulator score (285 +/- 94 versus 132 +/- 92, p < 0.001). The mean score on the written test was 242 (116). In total, only two surgeons achieved a passing score on both the cognitive and skills assessment required to obtain FLS certification. CONCLUSION: To our knowledge, this is the first time the FLS program has been taught in Africa. We have shown that giving the FLS course in a resource-restricted country is feasible and resulted in a significant improvement in FLS technical skills after 3 days. Most surgeons, however, still did not reach FLS passing scores, indicating that more than 3 days will be required in future courses to help surgeons obtain FLS certification.
INTRODUCTION: The use of laparoscopy in resource-restricted countries has increased in recent years. Although simulation is now considered an important adjunct to operating-room-based training for learning laparoscopic skills, there is very little literature assessing the use of simulation in resource-restricted countries. The purpose of this study was to determine the feasibility and impact of a 3-day Fundamentals of Laparoscopic Surgery (FLS) course in Botswana, Africa. METHODS: A total of 20 surgeons and trainees participated in a 3-day FLS course. A pretest FLS score was obtained for each subject, followed by 2 days of practice with feedback. A final FLS posttest score was then obtained. Participants also watched the FLS instructional CD-ROM and took the written test on day 3. RESULTS: Mean posttest scores were significantly higher than pretest scores for each FLS task and for the total normalized FLS simulator score (285 +/- 94 versus 132 +/- 92, p < 0.001). The mean score on the written test was 242 (116). In total, only two surgeons achieved a passing score on both the cognitive and skills assessment required to obtain FLS certification. CONCLUSION: To our knowledge, this is the first time the FLS program has been taught in Africa. We have shown that giving the FLS course in a resource-restricted country is feasible and resulted in a significant improvement in FLS technical skills after 3 days. Most surgeons, however, still did not reach FLS passing scores, indicating that more than 3 days will be required in future courses to help surgeons obtain FLS certification.
Authors: Neal E Seymour; Anthony G Gallagher; Sanziana A Roman; Michael K O'Brien; Vipin K Bansal; Dana K Andersen; Richard M Satava Journal: Ann Surg Date: 2002-10 Impact factor: 12.969
Authors: Gerald M Fried; Liane S Feldman; Melina C Vassiliou; Shannon A Fraser; Donna Stanbridge; Gabriela Ghitulescu; Christopher G Andrew Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
Authors: M C Vassiliou; G A Ghitulescu; L S Feldman; D Stanbridge; K Leffondré; H H Sigman; G M Fried Journal: Surg Endosc Date: 2006-02-27 Impact factor: 4.584
Authors: Daniel J Scott; E Matt Ritter; Seifu T Tesfay; Elisabeth A Pimentel; Alykhan Nagji; Gerald M Fried Journal: Surg Endosc Date: 2008-02-13 Impact factor: 4.584
Authors: M Schietroma; F Carlei; E Lezoche; A Agnifili; G N Enang; S Mattucci; S Minervini; N J Lygidakis Journal: Hepatogastroenterology Date: 2001 May-Jun