Traditional vs. Simulation Training for Laparoscopic Salpingectomy
BACKGROUND AND PURPOSE:
This study by Patel et al. (Journal of Minimally Invasive Gynecology, 2016) sought to determine if the use of a porcine training model improves the skills of ObGyn residents performing laparoscopic salpingectomies.
Randomized Control Trial (RCT)
22 OB/GYN residents performed a pre-intervention objective skills assessments test (OSAT) where they performed live human laparoscopic salpingectomy, after which they were randomized
The intervention group took part in one education session with a pre-session assigned reading, a 40-minute didactic lecture, watching of a procedural video, and simulation and practice of a laparoscopic salpingectomy using a porcine cadaver
The control group took part in traditional training
All students then performed a second laparoscopic salpingectomy on a live patient
Both surgeries were taped
Surgery tapes were scored by a single blinded evaluator for 9 OSAT indicators reflecting knowledge and skill
Secondary outcomes such as subjective measures of comfort with the surgery were assessed using surveys
A 5-point Likert scale was used (1=lowest score for OSAT and highest score for the subjective survey)
OSAT scores and comfort level measures did not change for the control group between the two surgeries
The intervention group significantly improved in 2-handed surgery (pre: 2.8 ± 1.6, post: 3.5 ± 1.3; p = .004) and use of energy (pre: 2.9 ± 1.3, post: 3.6 ± 1.0; p = .01)
The intervention group had an overall score change between the two procedures (pre: 26.7 ± 10.6, post: 29.9 ± 9.8; p ≤ .001)
On survey analysis for secondary outcomes among the intervention group
Comfort in anatomy, steps of surgery, 2-handed surgery, and use of energy increased
Comfort in reading and learning in the operating room decreased
Simulation can significantly improve surgical technique OSAT scores for laparoscopic salpingectomy
However, the authors note that while scores were statistically significantly improved, improvement was relatively small
Average scores for both groups were less than optimum, indicating that more than the simulation intervention used in this study will be required to increase resident’s surgical skills
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