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A Short Laparoscopic Drill That Improves Vaginal Cuff Closure at Different Institutions

Purpose: Evaluate whether a laparoscopic simulation drill improves performance on a validated vaginal cuff suturing task.

Background: The number of laparoscopic training materials available to teach gynecologic procedures is increasing; however, there is a lack of evidence showing that these methods result in improved surgical skills among obstetrics and gynecology (OB-Gyn) trainees.

Methods: OB-Gyn trainees at two academic institutions participated in laparoscopic teaching (15 minutes per trainee) using the \"eyelet\" simulation drill with a defined proficiency metric developed and conducted by a fellowship trained minimally invasive gynecologic surgeon. Pre- and post-teaching suturing tasks were recorded and scored blindly by the same physician using a validated vaginal cuff model and the Global Operative Assessment of Laparoscopic Skills (GOALS). Pre- and post-teaching surveys were administered to assess laparoscopic experience, Fundamentals of Laparoscopic Surgery (FLS) exposure, and opinions about the teaching.

Results: Among 25 participants, vaginal cuff suturing scores increased from a baseline median score of 5 (interquartile range [IQR] 2-5) to 7 (IQR 5-8) after teaching (p<0.001) with 92% of participants agreeing or strongly agreeing the simulation teaching was helpful for learning laparoscopic skills. The majority preferred the eyelet drill to FLS and felt the eyelet drill, rather than FLS, should be used for training and assessment.

Discussions: Simulation teaching was associated with improved vaginal cuff suturing performance. Short standardized drills, like the eyelet drill, should be evaluated in a larger sample with the ultimate goal of standardizing the Ob-Gyn laparoscopic training curriculum.

Topics: Minimally Invasive Surgery, Simulation, CME, GME, Practice-Based Learning & Improvement, Faculty, Resident, 2019, CREOG & APGO Annual Meeting,

General Information

Practice-Based Learning & Improvement,
Clinical Focus
Minimally Invasive Surgery,

Author Information

Tooba Anwer, MD, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center/Harvard Medical School; Anna Modest, PhD, MPH; Allyson Redhunt, BS; Melissa Lippitt, MD; Christopher DeStephano, MD, MPH; Hye-Chun Hur, MD

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