O. Kantor1, D. S. Loeff1, K. K. Roggin1, N. Schindler2, M. B. Ujiki2 1University Of Chicago,Department Of Surgery,Chicago, IL, USA 2Northshore University Health System,Department Of Surgery,Evanston, IL, USA
Introduction:
Implementation of curriculum-based skills modules have been successful in resident education across surgical disciplines. We hypothesized that skills modules in introduction to the laparoscopic tower, endoscopic tower, and laparoscopic abdominal access during surgery intern orientation would increase intern confidence and ability in these skills.
Methods:
In this intern orientation-based pilot of three introductory curriculum modules, six categorical general surgery interns underwent attending-led modules on introduction to the laparoscopic tower, endoscopic tower, and laparoscopic abdominal access. Both confidence and ability to perform the skill were assessed pre and post module on a 1-5 Likert scale (1=unable to do, 3=able to do with verbal cues, 5=able to do independently). Paired t-tests were used to compare means.
Results:
Of 6 interns, 1 had zero hours of simulation training in medical school, 3 had 1-5 hours, and 2 had 6-10 hours. History of simulation training did not correlate with pre-module confidence in any module (p>0.05).
The introduction to the laparoscopic tower module assessed the ability to identify components of the tower, completely set up the tower, assemble the scope, white balance the scope and turn on the insufflator, and troubleshoot an alarming insufflator. Intern confidence increased significantly from a pre-module mean of 2.83 to a post module mean of 4.77 (range 1-5 to 4-5, p<0.01). Ability to perform the skills increased from a pre-module mean of 3.12 to post-module mean of 4.97 (range 1-5 to 3-5, p<0.01).
The introduction to the endoscopic tower module assessed the ability to identify an upper and lower endoscope, identify the function of the buttons and dials, assemble the tower, and troubleshoot the scope camera. Intern confidence significantly increased from a pre to post module mean of 2.56 to 4.06 (range 1-4 to 2-5, p<0.01) and ability to perform the skills increased from a pre to post module mean of 3.90 to 5.00 (range 3-5 to 5, p<0.001).
The introduction to laparoscopic abdominal access assessed the ability to identify different approaches (Hassan, Veress, optical), explain complications and contraindications, and obtain abdominal access. Intern confidence significantly increased from a pre to post module mean of 1.90 to 3.90 (range 1-4 to 2-5, p<0.01). Due to time constraints, pre-testing was not assessed for the abdominal access module. On post-test, the mean score was 2.88 (range 1-4).
Conclusion:
Our pilot study showed a statistically significant increase in both intern confidence and ability to perform skills on three introductory modules. By incorporating these modules into surgery intern orientation, we were able to introduce important basic skills to better prepare for residency.