Jessica H Beard1, Larry Akoko2, Ally Mwanga2, Charles Mkony2, Patricia O'Sullivan3. 1. Department of Surgery, University of California, San Francisco, California. Electronic address: jessica.beard@ucsfmedctr.org. 2. Department of Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 3. Department of Medicine, University of California, San Francisco, California.
Abstract
OBJECTIVES: To explore the feasibility and effectiveness of guided practice using a low-cost laparoscopic trainer on the development of laparoscopic skills by surgeons in a resource-poor setting. DESIGN: This was a prospective trial involving a pretest/posttest single-sample design. Study participants completed a background survey and pretest on the 5 McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) tasks using a simulator developed and validated by researchers from the University of California, San Francisco. On completion of a 3-month guided practice course, participants were again tested on the MISTELS tasks and completed an exit survey. SETTING: The Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania. PARTICIPANTS: Fourteen Tanzanian surgery residents and specialists completed the study. RESULTS: Most of the subjects were surgical residents (64.3%). Only 2 participants (14.2%) had previous laparoscopic training, and baseline laparoscopic surgical experience was limited to intraoperative observation only. Study subjects practiced the MISTELS tasks for an average of 8.67 hours (range: 4.75-15.25) over the 3-month course. On the posttest, participants improved significantly in performance of each of the MISTELS tasks (p < 0.001). Total scores on the tasks increased from 24 ± 44 on the pretest to 384 ± 49 on the posttest (p < 0.001). All study participants were satisfied with the course, found the training personally valuable, and felt that their laparoscopic skills had improved on completion of the training. CONCLUSIONS: We have demonstrated the feasibility and effectiveness of training with a low-cost laparoscopic trainer box in Tanzania. Study participants achieved impressive posttest scores on the 5 MISTELS tasks with minimal baseline laparoscopic exposure. We feel that guided training by an expert was key in ensuring correct technique during practice sessions.
OBJECTIVES: To explore the feasibility and effectiveness of guided practice using a low-cost laparoscopic trainer on the development of laparoscopic skills by surgeons in a resource-poor setting. DESIGN: This was a prospective trial involving a pretest/posttest single-sample design. Study participants completed a background survey and pretest on the 5 McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) tasks using a simulator developed and validated by researchers from the University of California, San Francisco. On completion of a 3-month guided practice course, participants were again tested on the MISTELS tasks and completed an exit survey. SETTING: The Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania. PARTICIPANTS: Fourteen Tanzanian surgery residents and specialists completed the study. RESULTS: Most of the subjects were surgical residents (64.3%). Only 2 participants (14.2%) had previous laparoscopic training, and baseline laparoscopic surgical experience was limited to intraoperative observation only. Study subjects practiced the MISTELS tasks for an average of 8.67 hours (range: 4.75-15.25) over the 3-month course. On the posttest, participants improved significantly in performance of each of the MISTELS tasks (p < 0.001). Total scores on the tasks increased from 24 ± 44 on the pretest to 384 ± 49 on the posttest (p < 0.001). All study participants were satisfied with the course, found the training personally valuable, and felt that their laparoscopic skills had improved on completion of the training. CONCLUSIONS: We have demonstrated the feasibility and effectiveness of training with a low-cost laparoscopic trainer box in Tanzania. Study participants achieved impressive posttest scores on the 5 MISTELS tasks with minimal baseline laparoscopic exposure. We feel that guided training by an expert was key in ensuring correct technique during practice sessions.
Authors: Federico Gheza; Fadekemi O Oginni; Simone Crivellaro; Mario A Masrur; Adewale O Adisa Journal: World J Surg Date: 2018-11 Impact factor: 3.352
Authors: Norma E Farrow; Sarah J Commander; Christopher R Reed; Jenna L Mueller; Aryaman Gupta; Amos H P Loh; John Sekabira; Tamara N Fitzgerald Journal: Surg Endosc Date: 2020-11-17 Impact factor: 4.584