Skill acquisition and assessment for laparoscopic surgery

J. C. Rosser, L. E. Rosser and R. S. Savalgi
Department of Surgery, Yale University School of Medicine, New Haven, Conn., USA.

OBJECTIVES: To describe a training method with objective evaluation to enhance laparoscopic surgical skills to provide training in laparoscopic suturing techniques and to assess whether specific training exercises were helpful in the attainment of intracorporeal suturing skills. DESIGN: Trainees (N = 150) were asked to perform standardized drills with distinct mechanical features, and skill acquisition was determined by accuracy and timing. Trainees were tested for the ability to perform an intracorporeal laparoscopic suture before and after analogous skill training with the drills. SETTING: The training courses were held in teaching and nonteaching hospitals. PARTICIPANTS: Board-certified or board-eligible surgeons. MAIN OUTCOME MEASURES: Supervision by trained instructors and documentation of the time required to perform standardized drills. RESULTS: The trainees showed steady improvement in skill acquisition during 10 trials (P < .001). Significant (P < .001) improvement was noted for the performance of suturing after compared with before the drills. CONCLUSION: Three standardized laparoscopic drills have been tested in 150 trainees and demonstrate the incremental acquisition of skills that correlate with improved performance in a challenging and complex laparoscopic skill, intracorporeal suturing.