Is Laparoscopy Simulation Performance Correlated with Surgical Volume?
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
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
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
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
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
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