Four-year follow-up on a gynecologic laparoscopic skills curriculum and discussion of its implementation

Abstract

Introduction Simulation-based training of surgical skills is transferable to the operating room, but implementation of a specific skills curricula is still challenging. Ongoing efforts serve to identify and implement the optimal curriculum for ensuring patient safety. In 2013 the validated ‘basic laparoscopic skills curriculum’ was introduced for first-year residents in obstetrics and gynecology in Eastern Denmark. The aim of this study was to follow-up on implementation of the curriculum through a four-year period and identify facilitators and barriers. Material and method The ‘basic laparoscopic skills curriculum’ comprises four steps encompassing theoretical education (step 1 & 2) , proficiency-based technical skills training on virtual reality simulators (step 3), and a one-day surgical course with participants practicing procedures on sedated pigs (step 4) . All participants were first-year residents in obstetrics and gynecology in Eastern Denmark from September 2014 to August 2018. The ‘basic laparoscopic skills curriculum’ was administered by the Copenhagen Academy for Medical Education and Simulation (CAMES). Dropouts were asked to complete an electronic questionnaire on why they did not finish the curriculum. Results During the four-year follow-up, 107 first-year residents participated in the curriculum. One-hundred completed step three (93%) and 99 (92.5%) step 4. Participants spent a median of 249, IQR 164 minutes (min. 64, max. 630) on the virtual reality simulator. Median time for completing all four steps of the curriculum was 56 days, IQR 98 (min. 14, max 253). Conclusions Completion rates were continuously high over four years in this basic laparoscopic skills curriculum for residents. One likely reason is that the curriculum was partially mandatory, combined with a supportive management that allotted participation time. Self-directed learning, self-study and flexible booking are also considered as playing a crucial role.