Design of a Proficiency-Based Skills Training Curriculum for the Fundamentals of Laparoscopic Surgery

Abstract

Currently, no optimal curriculum exists for the Fundamentals of Laparoscopic Surgery (FLS) manual skills training program. The objective was to create a proficiency-based training curriculum that would allow both successful completion of the FLS manual skills exam and improved performance in the operating room. Two experienced laparoscopic surgeons performed 5 consecutive repetitions of all 5 FLS tasks. The mean performance times for both subjects were determined. Error parameters for each task were also recorded and used to establish a maximum allowable error parameter for each task. These data were used to create both error- and time-based proficiency levels for each task based on the importance of the task and the amount of resources consumed when practicing the task. This type of objective proficiency level was determined for each of the 5 FLS tasks. We have developed a proficiency-based training curriculum for the psychomotor skills portion of FLS. Work is under way to evaluate and validate this curricular design.

Keywords

laparoscopy education training simulation psychomotor skills

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References

Fried GM , Feldman LS , Vassiliou MC , et al. Proving the value of simulation in laparoscopic surgery. Ann Surg. 2004;240:518-528.

Peters J. , Fried GM , Swanstrom LL , et al. Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery. 2004;135:21-27.

Vassiliou M. , Ghitulescu G. , Feldman L. , et al. The MISTELS program to measure technical skill in laparoscopic surgery: evidence for reliability. Surg Endosc. 2006;20:744-747.

Gallagher A. , Ritter E. , Champion H. , et al. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg. 2005;241:364-372.

Grantcharov T. , Kristianson V. , Bendix J. , et al. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg. 2004;91:146-150.

McClusky D. , Gallagher A. , Ritter E. , et al. Virtual reality training improves junior residents' operating room performance: results of a prospective randomized, double-blinded study of the complete laparoscopic cholecystectomy. J Am Coll Surg. 2004;199:S73.

Ritter E. , Gallagher A. Proficiency based VR simulation training for peripheral intravenous access for 91W army medics: medicine meets virtual reality. Presented at: Medicine Meets Virtual Reality Conference; 2001 ; Long Beach, CA.

Seymour N. , Gallagher A. , Roman S. , et al. Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg. 2002; 236:458-464.

Korndorffer JR Jr, Dunne JB , Sierra R. , et al. Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg. 2005;201:23-29.

10.

Stefanidis D. , Korndorffer JR Jr, Markley S. , et al. Proficiency maintenance: impact of ongoing simulator training on laparoscopic skill retention. J Am Coll Surg. 2006;202: 599-603.

11.

Stefanidis D. , Sierra R. , Korndorffer JR Jr, et al. Intensive continuing medical education course training on simulators results in proficiency for laparoscopic suturing . Am J Surg. 2006;191:23-27.

12.

Fraser SA , Klassen DR , Feldman LS , et al. Evaluating laparoscopic skills: setting the pass/fail score for the MISTELS system. Surg Endosc. 2003;17:964-967.