Impact of Fundamentals of Laparoscopic Surgery Training During Medical School on Performance by First Year Surgical Residents

Edelman, David A.; Mattos, Mark A.; Bouwman, David L.

doi:10.1016/j.jss.2011.04.037

Cited by 12 publications

(3 citation statements)

References 21 publications

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“…The positive effects of training and education in laparoscopy has been shown in various publications. Edelman et al for example [5] described the impact of the integration of laparoscopic skill training in the medical school curriculum on the final surgical performance of residents. A French prospective study revealed that simulator training provides a more rapid acquisition of competence in surgical technique [1].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy in the public health system in Ecuador: an evaluation of the status quo and the education in minimally invasive surgery

Krentel

Ruiz²

2011

Gynecol Surg

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The following study describes the use of laparoscopic surgery in the public hospitals of the Ecuadorian ministry of public health in Quito, Ecuador in the year 2008. The aim of the present study was the description of the recent situation of laparoscopic surgery in the public sector of the Ecuadorian capital, the level of training and education of laparoscopists, and the determination of missing factors in the educational programs in minimally invasive surgery in Ecuador. We analyzed the use of laparoscopic approach in correlation to the specialty and the diagnosis. The results revealed that in many diagnoses, the standard surgical approach still is the laparotomy. The discrepancy between general surgery, gynecology, and urology in the use of minimally invasive surgery in the public health system shows the different educational levels and the need of training programs at university level and in the hospitals especially in gynecology.

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Section: Discussionmentioning

confidence: 99%

Laparoscopy in the public health system in Ecuador: an evaluation of the status quo and the education in minimally invasive surgery

Krentel

Ruiz²

2011

Gynecol Surg

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“…Only the American Fundamentals of Laparoscopic Surgery program, which focuses predominantly on manual psychomotor skills, has been validated 11,12…”

Section: Introductionmentioning

confidence: 99%

Design and implementation of a proficiency-based, structured endoscopy course for medical students applying for a surgical specialty

Win

Bruwaene

Allen³

et al. 2013

AMEP

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BackgroundSurgical simulation is becoming increasingly important in surgical education. Despite the important work done on simulators, simulator model development, and simulator assessment methodologies, there is a need for development of integrated simulators in the curriculum. In this paper, we describe the design of our evidence-based preclinical training program for medical students applying for a surgical career at the Centre for Surgical Technologies.MethodsTwenty-two students participated in this training program. During their final months as medical students, they received structured, proficiency-based endoscopy training. The total amount of mentored training was 18 hours and the training was organized into three training blocks. The first block focused on psychomotor training, the second block focused on laparoscopic stitching and suturing, and the third block on laparoscopic dissection techniques and hemostasis. Deliberate practice was allowed and students had to show proficiency before proceeding to the next training block. Students’ psychomotor abilities were tested before the course and after each training block. At the beginning of their careers as surgical registrars, their performance on a laparoscopic suturing task was compared with that of registrars from the previous year who did not have this training course. Student opinions about this course were evaluated using a visual analog scale.ResultsAll students rated the training course as useful and their psychomotor abilities improved markedly. All students performed deliberate practice, and those who participated in this course scored significantly (P < 0.0001) better on the laparoscopic suturing task than first year registrars who did not participate in this course.ConclusionOrganization of a structured preclinical training program in laparoscopy for final year medical students is feasible, attractive, and successful.

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“…FLS, and presumably FES, can be taught at all levels: medical school students, residents, and attending surgeons. In fact, early training in laparoscopic skills has translated into improved performance in early-level surgical residents [14]. Skill benefits may be realized early in surgical education, which will improve efficiency of training, quality, and patient safety.…”

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confidence: 99%

Why fundamentals of endoscopic surgery (FES)?

et al. 2013

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As flexible endoscopy has moved into the mainstream, gastroenterologists have embraced many of the skills and techniques particular to this modality of diagnosis and intervention. Their adoption of flexible endoscopic technology and training, and the lack of enthusiasm for endoscopic therapy potentials by surgeons, has left many surgical residents and practicing surgeons deficient in endoscopic skills. As a result, education of surgical residents in flexible endoscopy has lagged and training of surgical residents in flexible endoscopy is increasingly coming under scrutiny and has become an area of debate. The medical literature and practice guidelines are replete with articles from surgeons and gastroenterologists debating the appropriate education and training in flexible endoscopy. Both surgical and gastroenterology professional societies have published guidelines for training in flexible endoscopy. These guidelines are often at odds with each other, citing opposing literature supporting their position on appropriate criteria for training in basic upper and lower endoscopy [1][2][3][4]. Flexible endoscopy is a critical element of any general surgeon's and colorectal surgeon's practice. In 2007, 74 % of rural surgeons performed more than 50 flexible endoscopic procedures each year, with 42 % of rural surgeons performing more than 200 flexible endoscopic procedures annually [5]. In a 2010 report on rural, under-served areas that lack gastroenterology services, 39.8 % of an American general surgeons' practice comprises flexible endoscopic procedures [6]. In Canada, surgeons were found to be the primary providers of flexible endoscopic services in smaller urban and rural areas [7].The American Board of Surgery (ABS) has begun to address the training inequity that exists between general surgery residents and gastroenterology fellows [8]. In an effort to ensure surgical residents are fully trained and competent in flexible endoscopy, the ABS has not only increased the minimum requirements for training general surgery residents in flexible endoscopy but has also undertaken the task of formalizing a flexible endoscopy curriculum for its residents. Currently, the ABS and Residency Review Committee (RRC) recommend 35 upper endoscopic procedures and 50 colonoscopies as the minimum number of procedures to be performed by surgical residents. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and the ABS have long espoused that numbers do not ensure competency in surgical or endoscopic procedures. This position is fully supported by data. In 2004, the SAGES esophagogastroduodenoscopy (EGD) Outcomes Study Group prospectively reviewed 3,525 EGDs performed by surgeons, showing a high degree of success with low morbidity. There was no correlation between experience (i.e. number of cases performed) and completion rates or major complications [9]. A similar trial by the SAGES Colonoscopy Study Outcomes Group prospectively reviewed 13,580 colonoscopies performed by surgeons and found no correlation between ex...

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Impact of Fundamentals of Laparoscopic Surgery Training During Medical School on Performance by First Year Surgical Residents

Cited by 12 publications

References 21 publications

Laparoscopy in the public health system in Ecuador: an evaluation of the status quo and the education in minimally invasive surgery

Laparoscopy in the public health system in Ecuador: an evaluation of the status quo and the education in minimally invasive surgery

Design and implementation of a proficiency-based, structured endoscopy course for medical students applying for a surgical specialty

Why fundamentals of endoscopic surgery (FES)?

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