BACKGROUND AND PURPOSE:

• Simulation is an effective training method for surgical residents, including gynecologists
• There is less data on the use of surgical simulation for attending surgeons
• Mathews et al. (AJOG, 2017) sought to determine if simulation performance for validated laparoscopic virtual simulation tasks correlated with surgical volume, demographics and self-perception data of practicing ObGyns

METHODS:

• Most physicians who participated in this study were ‘low volume’ practitioners (0-1 laparoscopic/robotic procedure per month)
• 347 gynecologists with laparoscopic privileges were required to complete a laparoscopic surgery simulation assessment
• Average monthly laparoscopic procedures were divided up into 0-1/2-5/6-10/≥11
• Assessment included:
  • Pre-simulation survey gathering self-reported characteristics
  • 3 basic skills tasks on a virtual reality laparoscopic simulator (enforced peg transfer (PT), lifting and grasping (LG), and cutting (CT))
• Association between simulation outcome scores (time, efficiency, and errors) and self-rated clinical skills measures (self-rated laparoscopic skill score or surgical volume category), were examined with regression models

RESULTS:

• Laparoscopic volume was a significant predictor of
  • Total time on all three tasks
  • Two efficiency scores in PT, and all four efficiency scores in CT
  • Errors in LG and CT
• Self-rated laparoscopic skill level was a significant predictor of
  • total time in all tasks
  • nearly all efficiency scores and errors scores in all 3 tasks

CONCLUSION:

• High volume physicians and those with fellowship training were more confident and scored significantly higher in objective performance measures
• ObGyns were good at assessing their skills
• The authors suggest that busier surgeons with a high initial simulation score followed by ongoing high volume practice may not require yearly testing
• For gynecologists who have less volume, or if volume fluctuates, using virtual reality simulation may be helpful to maintain and improve skills

Learn More – Primary Sources:

Predictors of Laparoscopic Simulation Performance among Practicing Obstetrician Gynecologists

Related ObG Topics:

Traditional vs. Simulation Training for Laparoscopic Salpingectomy

Which are the Most Safe and Effective Female Sterilization Surgeries?

TLH vs. TAH for Endometrial Cancer – Results from the LACE trial