Shinichiro Yokoyama1, Yusuke Watanabe2,3,4, Yo Kurashima1,5, Akihiko Oshita6,7, Yuji Nishizawa8, Takeshi Naitoh9, Fumitaka Nakamura10, Satoru Kikuchi11, Kazuhiro Noma11, Saseem Poudel1,12, Akihiro Suzuki13, Yuichi Nishihara14, Masaaki Ito8, Satoshi Hirano1. 1. Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 2. Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan. ywatanabe328@gmail.com. 3. Department of Surgery, Teine Keijinkai Hospital, Sapporo, Japan. ywatanabe328@gmail.com. 4. Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan. ywatanabe328@gmail.com. 5. Clinical Simulation Center, Hokkaido University, Sapporo, Japan. 6. Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan. 7. Department of Gastroenterological and Transplant Surgery, Applied Life Science, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan. 8. Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan. 9. Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. 10. Department of Surgery, Teine Keijinkai Hospital, Sapporo, Japan. 11. Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan. 12. Department of General Surgery, Steel Memorial Muroran Hospital, Muroran, Japan. 13. Department of Gastrointestinal Surgery, St. Luke's International Hospital, Tokyo, Japan. 14. Department of Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.
Abstract
BACKGROUND: Recently, laparoscopic surgery (LS) has become a more common procedure than traditional open surgery. Although LS-related adverse events have been reported, there is no formal, standardized curriculum to teach the fundamentals of LS in Japan. Understanding surgeons' knowledge regarding LS is crucial for developing an educational curriculum. The purpose of this study was to determine the baseline knowledge on LS of surgeons and surgical trainees in Japan. METHODS: Participants completed 24 multiple-choice questions testing basic cognitive knowledge of LS and a questionnaire regarding the status of laparoscopic education. The examination was developed according to the 13 content domains of the Fundamentals of Laparoscopic Surgery (FLS) program. Scores were compared between post-graduate year (PGY) > 5 and PGY 1-5 participants. Data are expressed as median scores and interquartile ranges. Wilcoxon signed-rank test was used for statistical analysis. RESULTS: A total of 195 surgeons and surgical trainees from 10 teaching hospitals (PGY1-5: 66, PGY > 5: 129) across Japan completed the examination. The median score in the entire cohort was 75 [67; 83] %, with significantly higher scores in the PGY > 5 group compared to the PGY1-5 group (79 [75; 83] % vs. 67 [58; 75] %, p < 0.001). The differences in performance were due to better scores for PGY > 5 group on the sections "equipment," "patient considerations," "abdominal access," "tissue handling," "hemorrhage and hemostasis," "tissue approximation," and "exiting the abdomen." Overall, the median scores in the "energy sources" and "establishment and physiology of the pneumoperitoneum" subsections were lower than in other domains. All participants agreed on the need for fundamental knowledge and a formal educational curriculum. CONCLUSIONS: Compared to experienced surgeons, surgical trainees had lesser knowledge about performing LS. Regardless of the years of experience, there are crucial knowledge gaps in specific areas regarding safe LS that should be addressed by implementing an educational curriculum.
BACKGROUND: Recently, laparoscopic surgery (LS) has become a more common procedure than traditional open surgery. Although LS-related adverse events have been reported, there is no formal, standardized curriculum to teach the fundamentals of LS in Japan. Understanding surgeons' knowledge regarding LS is crucial for developing an educational curriculum. The purpose of this study was to determine the baseline knowledge on LS of surgeons and surgical trainees in Japan. METHODS:Participants completed 24 multiple-choice questions testing basic cognitive knowledge of LS and a questionnaire regarding the status of laparoscopic education. The examination was developed according to the 13 content domains of the Fundamentals of Laparoscopic Surgery (FLS) program. Scores were compared between post-graduate year (PGY) > 5 and PGY 1-5 participants. Data are expressed as median scores and interquartile ranges. Wilcoxon signed-rank test was used for statistical analysis. RESULTS: A total of 195 surgeons and surgical trainees from 10 teaching hospitals (PGY1-5: 66, PGY > 5: 129) across Japan completed the examination. The median score in the entire cohort was 75 [67; 83] %, with significantly higher scores in the PGY > 5 group compared to the PGY1-5 group (79 [75; 83] % vs. 67 [58; 75] %, p < 0.001). The differences in performance were due to better scores for PGY > 5 group on the sections "equipment," "patient considerations," "abdominal access," "tissue handling," "hemorrhage and hemostasis," "tissue approximation," and "exiting the abdomen." Overall, the median scores in the "energy sources" and "establishment and physiology of the pneumoperitoneum" subsections were lower than in other domains. All participants agreed on the need for fundamental knowledge and a formal educational curriculum. CONCLUSIONS: Compared to experienced surgeons, surgical trainees had lesser knowledge about performing LS. Regardless of the years of experience, there are crucial knowledge gaps in specific areas regarding safe LS that should be addressed by implementing an educational curriculum.
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