Impact of a University Laparoscopic Training Program on Dexterity and Vigilance Development.

Abstract

Background: The Fundamental of Laparoscopic Surgery (FLS) program, endorsed by the Society of American Gastrointestinal and Endoscopic Surgeons, has been instrumental in enhancing and assessing laparoscopic skills among trainees. However, whether a simulator-based training leads to trainees' awareness of their limitations remains unexplored. Participants and Methods: Twenty-one participants (10 novices and 11 experienced) were included, and categorized based on their participation in a laparoscopic training program held at the Saint Joseph University of Beirut. Trainees' development of basic and complex laparoscopic skills was assessed using standardized FLS tasks. Additionally, a questionnaire was administered to evaluate participants' satisfaction, confidence, and self-assessment levels during task execution. Results: Both groups completed the basic psychomotor tasks successfully, but the experienced group was significantly faster (p<0.005). Experienced participants were able to complete the intracorporeal knot versus half of novices (p=0.023), with the experienced group being better performing and faster. Most of experienced and none of novices manage to accomplish the end-to-end anastomosis. Both groups exhibited comparable levels of confidence, satisfaction, frustration, and difficulty perception. No significant distinction is found between the two groups in terms of performance self-rating. Also, no significant correlation is found between the levels of self-assessment and the objective scores of precision cutting and anastomosis among participants. Conclusion: This study reaffirms the effectiveness of simulation-based laparoscopic training for developing and retaining basic and complex surgical skills. While such training enhances stress management and self-confidence, it still insufficient to develop high level of vigilance and self-awareness.