Designing a Standardized Laparoscopy Curriculum for Gynecology Residents: A Delphi Approach

Abstract

Background Evidence suggests that simulation leads to improved operative skill, shorter operating room time, and better patient outcomes. Currently, no standardized laparoscopy curriculum exists for gynecology residents. Objective To design a structured laparoscopy curriculum for gynecology residents using Delphi consensus methodology. Methods This study began with Delphi methodology to determine expert consensus on the components of a gynecology laparoscopic skills curriculum. We generated a list of cognitive content, technical skills, and nontechnical skills for training in laparoscopic surgery, and asked 39 experts in gynecologic education to rate the items on a Likert scale (1–5) for inclusion in the curriculum. Consensus was predefined as Cronbach α of ≥ 0.80. We then conducted another Delphi survey with 9 experienced users of laparoscopic virtual reality simulators to delineate relevant curricular tasks. Finally, a cross-sectional design defined benchmark scores for all identified tasks, with 10 experienced gynecologic surgeons performing the identified tasks at basic, intermediate, and advanced levels. Results Consensus (Cronbach α = 0.85) was achieved in the first round of the curriculum Delphi, and after 2 rounds (Cronbach α = 0.80) in the virtual reality curriculum Delphi. Consensus was reached for cognitive, technical, and nontechnical skills as well as for 6 virtual reality tasks. Median time and economy of movement scores defined benchmarks for all tasks. Conclusions This study used Delphi consensus to develop a comprehensive curriculum for teaching gynecologic laparoscopy. The curriculum conforms to current educational standards of proficiency-based training, and is suggested as a standard in residency programs.

Expectations for Endoscopic Training During Gynaecological Specialty Training – Results of a Germany-wide Survey

“…This in turn demonstrates the junior doctorsʼ motivation to improve and expand their own skills through their personal commitment. At the international level, too, it has been shown that regular independent and mentor-guided training using simulators can improve technical skills, shorten surgery time and in turn, lead to better patient outcomes [1]. A standardized curriculum with respect to gynaecological endoscopic training is recommended.…”

Effect of structural training on surgical outcomes of residents’ first operative laparoscopy: a randomized controlled trial

“…As a consequence, the whole program became self-guided and easy to be trained. The contents of our theoretical course are relatively concordant to cognitive components in laparoscopic curricula published in England [6], North America [28], and Denmark [8]. Some curricula have the theoretical knowledge as a self-learning material on a separate CD-ROM, like Fundamentals of Laparoscopic Surgery (FLS) program [29] from the Society of American Gastrointestinal Endoscopic Surgeons, or on-line, like the Winners program from the European Society for Gynaecological Endoscopy (http://www.esge.com).…”

Perceptions and experience of veterinary surgery residents with minimally invasive surgery simulation training

“…Successful completion of the FLS curriculum prior to taking the certifying examination has been a requirement of the American Board of Surgery since 2008 . A similar approach with a different curriculum has been used for gynecology residents; this approach includes a 7‐week curriculum consisting of weekly 1‐hour didactic and interactive sessions, low‐fidelity box simulator, high‐fidelity virtual reality simulator technical skills and high‐fidelity team simulation . Shore et al found that participants in a simulation‐based curriculum had greater improvement in knowledge and technical performance in the operating room compared with a traditional residency program.…”