Encouraging Young Pediatric Surgeons and Evaluation of the Effectiveness of a Pediatric Endosurgery Workshop by Self-assessment and an Objective Skill Validation System: The Japan-Russia Medical Cooperation Project

Abstract

Background: Japanese pediatric endosurgery experts conducted a workshop for young pediatric surgeons in Russia in collaboration with Russian expert pediatric surgeons. This study was aimed to develop a contributive workshop program and evaluate its impact on young Russian pediatric surgeons. Methods: A two-day pediatric endosurgery workshop was held in Russia. After conducting a needs assessment survey, Japanese and Russian faculties developed the workshop contents, including pre- and post-workshop skills assessments, lectures and hands-on training. Skills assessments were performed using the objective skill validation system, the “A-Lap Mini”, mimicking intestinal anastomosis. The trainees self-evaluated their knowledge and skills using a five-point scale.Results: Fifteen novice Russian trainees participated and 14 (93.3%) completed the workshop. The completion rate for the suturing task before and after the workshop was 40.0% (6/15) and 85.7% (12/14), respectively. The following five skill evaluation criteria, which were objectively evaluated, improved: performance time changed from 751.6 ± 247.1 s to 780.0 ± 313.3 s (p>0.05), number of full-thickness sutures improved from 1.0 ± 1.41 to 2.64 ± 0.84 (p=0.003), area of wound-opening changed from 0.42 ± 0.83 mm2 to 0.53 ± 1.13 mm2, suture tension improved from 55.48 ± 19.51% to 61.95 ± 23.91% (p>0.05), and maximum air leakage pressure improved from 3.76 ± 2.11 kPa to 8.42 ± 7.68 kPa (p>0.05). Regarding the self-assessed questionnaire administered before and after the workshop, the confidence in endosurgery skills significantly improved as follows: forceps manipulation ability improved from 2.7 to 3.7 (p<0.05), and suturing performance improved from 2.5 to 3.6 (p<0.05). The usefulness of the workshop for clinical surgery was scored at 4.3.Conclusions: Quantitative skill evaluation with an automatic feedback function was useful for endosurgery training. Delivering feedback concerning the assessment results to the trainee helps them to determine the specific training requirements needed for clinical endosurgery.