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Published in: Surgical Endoscopy 12/2022

21-03-2022 | Cholecystectomy | 2021 SAGES Oral

Resident performance in simulation module is associated with operating room performance for laparoscopic cholecystectomy

Authors: Yohei Kojima, Harry J. Wong, Kristine Kuchta, Woody Denham, Stephen Haggerty, John Linn, Michael Ujiki

Published in: Surgical Endoscopy | Issue 12/2022

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Abstract

Background

Simulation is an important tool in surgical training. However, the transferability of skills obtained in the simulation setting to the operating room (OR) is uncertain. This study explores the association between resident simulation performance and OR performance in a laparoscopic cholecystectomy (LC) simulation module.

Methods

A simulation module focused on LC utilizing a virtual reality simulator was completed by general surgery residents. Simulation performance was evaluated using the validated Global Operative Assessment of Laparoscopic Skills (GOALS) and Objective Structured Assessment of Technical Skills (OSATS), as well as a LC-specific simulation assessment form (LC-SIM). Resident subsequent OR performances of LC were measured by the Surgical Training and Assessment Tool (STAT), an online mobile-based evaluation completed by attending surgeons.

Results

Twenty-one residents who completed the simulation module and also with STAT data on LC from 2016 to 2020 were included. Higher scores on incision/port placement on LC-SIM is associated with better tissue handling (coefficient 0.20, p = 0.048) and better time & economy of motion on STAT (coefficient 0.22, p = 0.037). However, higher scores on time and motion on OSATS are associated with worse tissue handling (− 0.28, p = 0.046), worse time & economy of motion (− 0.37, p = 0.009), and worse overall grade (− 0.21, p = 0.044). Higher scores on overall performance on OSATS is associated with worse time & economy of motion (− 0.80, p = 0.008). Higher scores on depth perception on GOALS are associated with worse tissue handling (− 0.28, p = 0.044).

Conclusion

We found significant positive and negative associations between resident simulation performance and OR performance, particularly in tissue handling and economy of motion. This could suggest that simulation performance does not reliably predict OR performance. However, this could highlight the concept of excessive caution in the real OR environment and longer operative time which could be interpreted as worse time and economy of motion by the attending surgeons.
Literature
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go back to reference Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondré K, Stanbridge D, Fried GM (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190:107–113CrossRefPubMed Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondré K, Stanbridge D, Fried GM (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190:107–113CrossRefPubMed
Metadata
Title
Resident performance in simulation module is associated with operating room performance for laparoscopic cholecystectomy
Authors
Yohei Kojima
Harry J. Wong
Kristine Kuchta
Woody Denham
Stephen Haggerty
John Linn
Michael Ujiki
Publication date
21-03-2022
Publisher
Springer US
Keyword
Cholecystectomy
Published in
Surgical Endoscopy / Issue 12/2022
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-022-09152-7

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