Development of a laparoscopic surgical skills simulation curriculum: Enhancing resident training through directed coaching and closed-loop feedback.

Autor: Lovasik BP; Department of Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address: https://twitter.com/blovasik., Fay KT; Department of Surgery, Emory University School of Medicine, Atlanta, GA., Patel A; Department of Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address: https://twitter.com/ankitpatelmd., Stetler J; Department of Surgery, Emory University School of Medicine, Atlanta, GA., Papandria D; Department of Surgery, Emory University School of Medicine, Atlanta, GA., Santore MT; Department of Surgery, Emory University School of Medicine, Atlanta, GA., Davis SS; Department of Surgery, Emory University School of Medicine, Atlanta, GA., Lin E; Department of Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address: https://twitter.com/edlinemory., Srinivasan JK; Department of Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address: jsrini2@emory.edu.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2022 Apr; Vol. 171 (4), pp. 897-903. Date of Electronic Publication: 2021 Sep 11.
DOI: 10.1016/j.surg.2021.08.020
Abstrakt: Background: Performance feedback through peer coaching and rigorous self-assessment is a critical part of technical skills improvement. However, formal collaborative programs using operative video-based skills assessments to generate peer coaching feedback have only been validated among attending surgeons. In this study, we developed a unique longitudinal, simulation video-based laparoscopic skills resident curriculum using video-based peer coaching and evaluated its association with skills acquisition among surgical trainees.
Methods: The laparoscopic simulation curriculum consists of a pre-practice laparoscopic skill video recording, followed by receipt of directed coaching and feedback on performance from a faculty coach, a peer coach, and self-coaching. Residents then completed 6 weeks of feedback-directed practice and submitted a second post-practice laparoscopic skill video recording of the same skill, which was evaluated by a minimally invasive surgery expert grader. All general surgery residents in a single institution were enrolled, with 107 residents completing the curriculum in its initial 2 years.
Results: Overall, more than two-thirds of residents achieved skills proficiency on their expert assessments, with similar rates of residents achieving skills proficiency at all postgraduate year levels. Significant improvements between the pre-practice assessments and post-practice assessments were most frequently seen in the instrument handling, precision, and motion & flow categories (P < .05 each). Faculty provided the highest number and proportion of closed-loop comments; residents' self-coaching feedback had the lowest number of closed-loop comments, with 83% of self-assessments containing none.
Conclusion: In this study, we describe the successful implementation of a longitudinal laparoscopic skills video-based coaching curriculum designed to improve residents' laparoscopic technical abilities through iterative directed practice supplemented by formative closed-loop feedback. This feasible, reproducible, and low-cost simulation curriculum can be adapted to other training programs and skills acquisition endeavors. This program also prepares trainees for ongoing performance feedback after completion of residency through rigorous self-assessment and peer-to-peer coaching.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: