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PWE-417 Incentivising laparoscopic deliberate practice in core surgical training
  1. LG Nicol1 on behalf of Scottish Surgical Simulation Collaborative,
  2. R Partridge2 on behalf of Scottish Surgical Simulation Collaborative,
  3. J Cleland3 on behalf of Scottish Surgical Simulation Collaborative,
  4. S Moug4 on behalf of Scottish Surgical Simulation Collaborative,
  5. A Paisley5 on behalf of Scottish Surgical Simulation Collaborative,
  6. I Ahmed6 on behalf of Scottish Surgical Simulation Collaborative,
  7. KG Walker1 on behalf of Scottish Surgical Simulation Collaborative and Scottish Surgical Simulation Collaborative
  1. 1General Surgery, NHS Highland, Inverness
  2. 2Paediatric Surgery, NHS Lothian, Edinburgh
  3. 3Medical Education, University of Aberdeen, Aberdeen
  4. 4General Surgery, NHS Greater Glasgow & Clyde, Paisley
  5. 5General Surgery, NHS Lothian, Edinburgh
  6. 6General Surgery, NHS Grampian, Aberdeen, UK

Abstract

Introduction Frequent practice using a laparoscopic simulator is known to improve subsequent live operating skills. Achieving automation of motor movements prior to live training frees the trainee’s attention for higher skills. Despite this, trainees don’t avail themselves of opportunity for practice. We incentivised frequent laparoscopic practise within two Core Surgical Training (CST) programmes.

Method 27 CST’s in their first general/urology/paediatric post were given a take-home laparoscopic simulator with instrument tracking software and assigned 6 online modules. Support was provided via social media and a helpdesk. Achievement of metric targets and uploading specified data merited an eCertificate. On production of this certificate, supervisors progressed trainees from camera-holding to operating (the incentive). Trainee views of the intervention and laparoscopic practice were assessed by questionnaires.

Results Metric results show improvement across all domains for those who completed 1 or more modules (presented graphically). Trainee self-rated anxiety of laparoscopic operating was reduced post-study. 94% of participants thought simulator practise was worthwhile, 76% would recommend the programme. 88% reported improved confidence and motor skills. 41% of participants completed >1 modules. 19% completed all. Comments indicated reasons for this, including the need to integrate simulation into curricular structures. Metric results showed improvement in 5 domains Motion smoothness, acceleration, speed, distance between instruments,% time off screen + time to completion.

Conclusion The message from this feasibility study, the first to “incentivise” laparoscopic practice, indicates that simply incentivising practice with 24/7 access to simulators and targets, doesn't result in frequent deliberate practice by trainees, though performance improves in those who do engage. Trainee feedback provides clear indicators of what to address to maximise uptake. It would suggest that to fully engage trainees, laparoscopic practice must be fully integrated into training and progress assessed within training.

Disclosure of interest L. Nicol: None Declared, R. Partridge Conflict with: Founder of E-O surgical, J. Cleland: None Declared, S. Moug: None Declared, A. Paisley: None Declared, I. Ahmed: None Declared, K. Walker: None Declared.

References

  1. Nagendran M, et al. Laparoscopic surgical box model training for surgical trainees with no prior laparoscopic experience. Cochrane Database Syst Rev. 2014;1

  2. Dawe SR, et al. A Systematic Review of Surgical Skills Transfer After Simulation-Based Training Laparoscopic Cholecystectomy and Endoscopy. Ann Surg. 2014;259(2)

  3. Zapf MA, Ujiki MB. Surgical resident evaluations of portable laparoscopic box trainers incorporated into a simulation-based minimally invasive surgery curriculum. Surg Innov. 2015;22(1):83–7

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