Purpose: To evaluate change in resident confidence in laparoscopic skills and identification and dissection retroperitoneal anatomy and satisfaction with a human cadaver simulation.
Background: Laparoscopy is fundamental to gynecologic practice. Residencies develop innovative surgical curriculums to prepare trainees to be competent minimally invasive surgeons. A human cadaver simulation is one unique opportunity for surgical training.
Methods: This prospective cohort study included residents in a single academic institution. Trainees performed a 7-hour guided simulation. Using cadaver models, residents identified anatomy, performed laparoscopic dissections and procedures. Participants completed surveys before and after to assess knowledge and confidence with laparoscopic techniques. Questions were close-ended utilizing a numerical rating scale.
Results: Overall, 16 out of 19 residents (84%) found the exercise ‘extremely helpful’ in increasing laparoscopic skills and understanding retroperitoneal anatomy. Senior residents averaged higher confidence scores compared to junior residents in all areas before and after simulation. The junior residents showed a greater increase in confidence in laparoscopic entry and ureteral retroperitoneal dissection (increased score by 2.5 and 3.3) compared to senior residents (increased score by 1.4 and 2.6). While all residents nearly doubled their average confidence scores with pararectal and paravesical spaces, a greater increase was observed among senior residents (2.8 and 2.7 compared to 2.7 and 2.4).
Discussions: These results suggest that residents have significantly increased confidence laparoscopically and understanding of anatomy after completion of this human cadaver model. While there are limits of cost, this study indicates educational value for the training gynecologist. Long-term data is needed to determine the longevity of this knowledge.
Topics: CREOG & APGO Annual Meeting, 2021, Student, Resident, Clerkship Director, Residency Director, Medical Knowledge, Practice-Based Learning & Improvement, GME, Assessment, Simulation, Minimally Invasive Surgery,
Allyson Jang, MD, UC Davis Medical Center; Nuria Garcia-Ruiz, MD; Behareh Nejad, MD
