To assess self-confidence and to demonstrate the benefits of embedding structured simulation programs into gynaecology curriculums.
Design:
Initially survey assessment (covering knowledge, skills and confidence) disseminated to 60 trainees (20 basic, intermediate and advanced), followed by a laparoscopic simulation course and repeat survey.
Setting:
NHS ‘Deanery’ regional training program.
Patients or Participants:
Early to late-stage gynaecology residents.
Interventions:
Trainees received laparoscopic-box trainers (Inovus LapAR) and then four in-person sessions supplemented by lectures & practical exercises.
Measurements and Main Results:
When rating their laparoscopic skills overall 45%, 52.8% and 80% positively in the basic, intermediate and advanced groups respectively. 25%/35% in the basic, 76.47%/70.59% in the intermediate and 100%/100% in the advanced group felt confident in performing safe entry/diagnostic laparoscopy. 10% in the basic group felt confident in performing salpingectomy compared to 58.82%/100% in the intermediate/advanced groups. 23.55% in the intermediate group felt confident in performing ovarian cystectomy compared to 60% in the advanced. 6.25%/23.53% and 20%/20% of intermediate and advanced trainees felt confident in performing hysterectomy/suturing. No trainees felt confident performing myomectomy.
Across all 60 trainees there was a statistically significant (p=<0.05) improvement in smoothness, time and speed. Within the beginner and intermediate groups there was a statistically significant (p=<0.05) improvement in laparoscopic knowledge, skills and confidence with beginner and intermediate operations (diagnostic laparoscopy, salpingectomy). Within the advanced group there was a statistically significant (p=<0.05) improvement in their confidence with advanced skills and operations (suturing, myomectomy, hysterectomy).
Conclusion:
Across all streams, an imbedded simulation programme significantly improves surgical performance. Despite high confidence for simple procedures, it is clear from the initial survey that confidence falls as complexity of the procedures increase. However, following the course, trainees in the basic stream showed the most significant improvement across all parameters measured, highlighting the benefits of embedding structured simulation programmes into the curriculum early in the training programme.
Rawaf, DL*1, Mallick, R2, Beard, L3, Abdulkader, N4, Adamczyk, M5, Bryony, C6, Harvey, N6. 1Inovus Medical, NHS, London, United Kingdom; 2University Hospitals Sussex NHS Foundation Trust, Princess Royal Hospital, Hawards Heath, United Kingdom; 31University Hospitals Sussex NHS Foundation Trust, Princess Royal Hospital, Haywards Heath, United Kingdom; 4Barts Health, London, United Kingdom; 5St Peters Hospital, Chertsey, United Kingdom; 6University Hospitals Sussex NHS Foundation Trust, St Richards Hospital, Chichester, United Kingdom