Laparoscopic skills training and assessment

Aggarwal, Rajesh; Moorthy, Krishna; Darzi, Ara

doi:10.1002/bjs.4816

Cited by 417 publications

(286 citation statements)

References 61 publications

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“…Laparoscopy, one of the most common MIS approaches, has been adopted by several surgical sub-specialties, including gastrointestinal, gynecologic, and urologic surgeries [2]. Effective training and assessment of surgeons in these new techniques have become one of the major concerns of hospitals and clinics in recent years, fuelled mostly by patients' and society's demands for safer surgeries and well prepared physicians [3][4][5][6].…”

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confidence: 99%

“…Traditional Halsted-based training [7] is potentially unsafe for the patient and, as a consequence, no longer ethically sustainable [4]. There is a tendency to move the early phases of training, concerned with the acquisition of motor skills, outside the OR.…”

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confidence: 99%

“…There is a tendency to move the early phases of training, concerned with the acquisition of motor skills, outside the OR. For this reason, laboratory settings including, for example, box trainers and/or virtual reality (VR) simulators have been developed [4].…”

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confidence: 99%

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Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

133

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Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentortrainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons' psychomotor skills. Ongoing development of tracking systems and software Solutions has allowed for the expansión of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentáis of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as 1 To whom correspondence and reprint requests should be addressed at Bioengineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Universidad Politécnica de Madrid (UPM). Avda Complutense, 30, 28040, Madrid, Spain. E-mail: ioropesa@gbt.tfo. upm.es. well as optimize their already overloaded training schedules.

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Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

133

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“…MIS techniques have improved patient safety, reduced tissue damage, decreased morbidity, and shortened the duration of hospital stays for patients. However, MIS techniques imply a different and limited interaction paradigm compared with the traditional open approach [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, itis gradually beingreplaced by new reproducible and flexible methods in which active learning is encouraged. Effective training and assessment of surgeons has become one of the major concerns of hospitals and clinics in recentyears, fuelled mostly by patients'and society's demands for safer surgeries and better-prepared physicians [2]. The development of standardized training processes is the key to success in the optimization of the trainee's learning curve, whereas proper accreditation relies on developing objective curricula in which personal bias can be reduced to a minimum.…”

Section: Introductionmentioning

confidence: 99%

TELMA: Technology-enhanced learning environment for minimally invasive surgery

Sánchez-González

Burgos

García

et al. 2013

Journal of Surgical Research

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Background: Cognitive skills training for minimally invasive surgery has traditionally relied upon diverse tools, such as seminars or lectures. Web technologies for e-learning have been adopted to provide ubiquitous training and serve as structured repositories for the vast amount of laparoscopic video sources available. However, these technologies fail to offer such features as formative and summative evaluation, guided learning, or collaborative interaction between users.

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The Formula for a Successful Laparoscopic Skills Curriculum

Stefanidis

Heniford²

2009

Arch Surg

156

109

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Although multiple simulators have been validated as effective training tools, curriculum development is lagging, and considerable work is needed to determine the best methods for training. This article identifies the factors that influence the successful incorporation of simulator training into the resident curriculum, reviews the evidence regarding laparoscopic curriculum development in the surgical literature, and provides a formula for effective curriculum design. A successful laparoscopic skills curriculum depends on many factors including participant motivation, available resources and personnel, and trainee and faculty commitment. It should encompass goal-oriented training, sensitive and objective performance metrics, appropriate methods of instruction and feedback, deliberate, distributed, and variable practice, an amount of overtraining, maintenance training, and a cognitive component. A curriculum that follows these principles is likely to spark trainee interest, ensure their satisfaction and participation in training sessions, and lead to an effective and efficient way of acquiring new skills using simulators. A skills curriculum is a dynamic process that should be tailored to individual needs and be continuously optimized based on accumulated evidence and experience.

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Laparoscopic skills training and assessment

Abstract: The tools are now available for the development of a structured, competency-based, laparoscopic surgical training programme.

Cited by 417 publications

References 61 publications

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

TELMA: Technology-enhanced learning environment for minimally invasive surgery

The Formula for a Successful Laparoscopic Skills Curriculum

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