BACKGROUND: Despite the proven utility of laparoscopy in pediatric urology, widespread adoption of the surgical approach has been limited. The Fundamentals of Laparoscopic Surgery (FLS) is a reliable teaching mode for surgeons. Our study objective was to evaluate the effectiveness of a laparoscopic training course via a performance based assessment of participants' technical skills on the FLS module. MATERIALS AND METHODS: The laparoscopic pediatric urology course, administered to 18 fellows, consisted of a 6-h didactic session and a full d practice on a live porcine model. FLS skills were practiced prior to and immediately following the course, and included peg transfer, precision pattern cutting, securing a ligating loop, and intracorporeal suturing. Written exams were used to evaluate participants' cognitive knowledge about laparoscopic procedures. Pretest and post-test performances were compared using paired t-tests. Previous laparoscopic caseload was addressed as a potential predictor of performance using two separate Pearson correlations between total caseload and performance scores. RESULTS: Participation in the course led to significant improvements in FLS and written exam scores. Laparoscopic caseload was correlated with pretest performance (R = 0.53, P < 0.05) though this correlation was not significant at post-test (R = 0.41, P > 0.05). However, the improvement from pretest to post-test (i.e., difference score) was significantly related to the participants' pediatric laparoscopic caseload (R = -0.47, P < 0.05). CONCLUSIONS: Operative experience is instrumental in attaining laparoscopic skills. However, intensive simulation-based training improves technical performance and cognitive knowledge competence, especially for novice trainees. Long-term assessment of trainees is required to ascertain the effectiveness of this approach to laparoscopic training. Copyright 2010 Elsevier Inc. All rights reserved.
BACKGROUND: Despite the proven utility of laparoscopy in pediatric urology, widespread adoption of the surgical approach has been limited. The Fundamentals of Laparoscopic Surgery (FLS) is a reliable teaching mode for surgeons. Our study objective was to evaluate the effectiveness of a laparoscopic training course via a performance based assessment of participants' technical skills on the FLS module. MATERIALS AND METHODS: The laparoscopic pediatric urology course, administered to 18 fellows, consisted of a 6-h didactic session and a full d practice on a live porcine model. FLS skills were practiced prior to and immediately following the course, and included peg transfer, precision pattern cutting, securing a ligating loop, and intracorporeal suturing. Written exams were used to evaluate participants' cognitive knowledge about laparoscopic procedures. Pretest and post-test performances were compared using paired t-tests. Previous laparoscopic caseload was addressed as a potential predictor of performance using two separate Pearson correlations between total caseload and performance scores. RESULTS: Participation in the course led to significant improvements in FLS and written exam scores. Laparoscopic caseload was correlated with pretest performance (R = 0.53, P < 0.05) though this correlation was not significant at post-test (R = 0.41, P > 0.05). However, the improvement from pretest to post-test (i.e., difference score) was significantly related to the participants' pediatric laparoscopic caseload (R = -0.47, P < 0.05). CONCLUSIONS: Operative experience is instrumental in attaining laparoscopic skills. However, intensive simulation-based training improves technical performance and cognitive knowledge competence, especially for novice trainees. Long-term assessment of trainees is required to ascertain the effectiveness of this approach to laparoscopic training. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: Melanie L Hafford; Kent R Van Sickle; Ross E Willis; Todd D Wilson; Kristine Gugliuzza; Kimberly M Brown; Daniel J Scott Journal: Surg Endosc Date: 2012-07-07 Impact factor: 4.584