Purpose: To gather validity evidence for a laparoscopic salpingectomy
model developed for resident training.
Background: Laparoscopic salpingectomy is a milestone procedure
for gynecologic trainees and is commonly performed in the management of ectopic
pregnancies. Opportunities to practice the use of electrosurgical devices prior
to the operating room can be limited. An animal tissue model was developed and
previously piloted at our institution for this purpose, and was modified to
include a pelvic sidewall and ovaries.
Methods: 25 simulations of laparoscopic salpingectomy were
performed by 14 trainees (5 PGY-1, 4 PGY-2, 1 PGY-3, 4 PGY-4). For
analysis purposes the PGY-3 and PGY-4 trainees were combined. Each
trainee received scripted instructions and reviewed a video with proper
technique beforehand. These recordings were evaluated by 2 blinded gynecologic
surgeons using the Global Operative Assessment of Laparoscopic Skills (GOALS)
and Objective Structured Assessment of Laparoscopic Salpingectomy (OSA-LS).
Results: There was good agreement between the graders with
intraclass correlation coefficients of 0.63 and 0.79, respectively, for GOALS
and OSA-LS. The mean GOALS score increased with experience (10,
13.2, and 15.5 for PGY-1, PGY-2, and PGY-3/4, respectively) and was
significantly different between PGY-1 and PGY-3/4 (two-sample t-test, p=0.004).
The mean OSA-LS score increased with experience (8.9, 14.2, and 16.2 for PGY-1,
PGY-2, and PGY-3/4) and was significantly different between PGY-1 and PGY-2
(p=0.006) and between PGY-1 and PGY-3/4 (p< 0.001).
Discussions: This training model and rubrics differentiated
experienced and novice trainees and could be used to establish a preoperative
competency benchmark.
Topics: CREOG & APGO Annual Meeting, 2020, Student, Resident, Faculty, Residency Director, Practice-Based Learning & Improvement, GME, Assessment, Simulation, Minimally Invasive Surgery, General Ob-Gyn,
Sharon Kim,
MD; Mayo; Amy
Weaver, MS; Daniel Breitkopf, MD; Isabel Green,
MD;
