New dog, new tricks: trends in performance on the Fundamentals of Laparoscopic Surgery simulator for incoming surgery residents

Kolozsvari, Nicoleta O.; Kaneva, Pepa; Vassiliou, Melina C.; Fried, Gerald M.; Feldman, Liane S.

doi:10.1007/s00464-011-1829-4

Cited by 10 publications

(3 citation statements)

References 19 publications

(25 reference statements)

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“…The introduction of MIS represents a new skill set that may have minimal overlap with the open approach. Despite some indications that new trainees come to surgical residency better prepared to learn MIS, 10 a recent survey of program directors found that achieving proficiency with MIS procedures involves steep learning curves and that most residents require more procedures than the Resident Review Committee currently requires. 2,4,11 Recent resident surveys echo these concerns; many respondents believe additional laparoscopic training after residency is necessary to achieve competence.…”

Section: Discussionmentioning

confidence: 95%

A National Review of the Frequency of Minimally Invasive Surgery Among General Surgery Residents

et al. 2015

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Section: Discussionmentioning

confidence: 95%

A National Review of the Frequency of Minimally Invasive Surgery Among General Surgery Residents

et al. 2015

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“…16 students Laparoscopic suturing and knot tying Video-based performance assessment tool on live porcine Kolozsvari et al [25] 2012 63 residents FLS tasks 1 FLS scoring system Kurashima et al [26] 2013 17 residents Laparoscopic inguinal hernia repair GOALS-GH Langelotz et al [27] 2005 150 surgeons Navigation, coordination, grasping, cutting and clipping VR simulators LeBlanc et al [28] 2010 29 surgeons Laparoscopic sigmoid colectomy ProMIS™ simulator, OSATS and operative error Lehmann et al [29] 2012 36 surgeons 2 LapSim tasks LapSim Lehmann et al [30] 2013…”

Section: Lapmentormentioning

confidence: 99%

Evaluation of surgical training in the era of simulation

Shaharan

Neary

2014

WJGE

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AIM:To assess where we currently stand in relation to simulator-based training within modern surgical training curricula. METHODS:A systematic literature search was performed in PubMed database using keywords "simulation", "skills assessment" and "surgery". The studies retrieved were examined according to the inclusion and exclusion criteria. Time period reviewed was 2000 to 2013. The methodology of skills assessment was examined. RESULTS:Five hundred and fifteen articles focussed upon simulator based skills assessment. Fifty-two articles were identified that dealt with technical skills assessment in general surgery. Five articles assessed open skills, 37 assessed laparoscopic skills, 4 articles assessed both open and laparoscopic skills and 6 assessed endoscopic skills. Only 12 articles were found to be integrating simulators in the surgical training curricula. Observational assessment tools, in the form of Objective Structured Assessment of Technical Skills (OSATS) dominated the literature. CONCLUSION:Observational tools such as OSATS remain the top assessment instrument in surgical training especially in open technical skills. Unlike the aviation industry, simulation based assessment has only now begun to cross the threshold of incorporation into mainstream skills training. Over the next decade we expect the promise of simulator-based training to finally take flight and begin an exciting voyage of discovery for surgical trainees. Core tip: The nature of surgical training has teetered on the brink of a seismic change in how we can deliver the level of expertise required of a modern surgeon for over a decade. It is evolving from Halstedian's apprenticeship model towards simulation-based training similar to the aviation industry. Since 2000 there have been approximately 173 studies about validation of simulators as assessment tools. As the technology grows, its translation into real changes in curriculum is still unclear. This review is focused upon where we currently stand in relation to the effective integration of simulation-based skills assessment into modern surgical training curricula.Shaharan S, Neary P. Evaluation of surgical training in the era of simulation. World J Gastrointest Endosc 2014; 6(9): 436-447 Available from:

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“…With the ABS adoption of FLS training as a requirement for all surgeons before board eligibility, it is our hope the ABS will take a similar path with FES. Adoption and implementation of FLS after the ABS mandate has been an unmitigated success [15,16]. In a 2010 article, the Controlled Risk Insurance Company of Harvard's Risk Management Foundation (CRICO/RMF) sponsored an FLS course for its surgeons with the anticipated result of advancing competency and patient safety [17].…”

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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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New dog, new tricks: trends in performance on the Fundamentals of Laparoscopic Surgery simulator for incoming surgery residents

Abstract: The baseline fundamental laparoscopic skills of incoming surgery residents appear to have improved over time. This may be due to increased clinical laparoscopic exposure and availability of laparoscopic simulation in medical school.

Cited by 10 publications

References 19 publications

A National Review of the Frequency of Minimally Invasive Surgery Among General Surgery Residents

A National Review of the Frequency of Minimally Invasive Surgery Among General Surgery Residents

Evaluation of surgical training in the era of simulation

Why fundamentals of endoscopic surgery (FES)?

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