Objective Assessment of Surgical Skills in a 2-Day Visceral Anastomosis Techniques Course hold in the Annual Congress of the German Surgical Society (DGCH)

Abstract

Introduction: Simulation skill Laboratories are being increasingly marketed from different institutions and are widely accepted in Europe and the USA. Furthermore, residency training programs in the USA are incorporating such Laboratories into their residency curricula after being mandated by the American College of Surgery (ACS) in 2008 and are using them in the last few years to evaluate the competency of their surgical residents. Unlike to North America, the literature to date has shown a little, when none about simulation skill labors/Curricula despite their existence in private institutes or few residency training programs in Europe. We still rely mainly on our traditional training methods and surgical simulators are still predominantly aimed at attracting attention at surgical equipment exhibits. One of the well-known simulation skill Laboratories in Germany is hold yearly since 2005 in the annual German surgical meetings (DGCH). This Skill Laboratory is subdivided into different courses over 4 days with different modules in station-setting which includes common trunk surgical skills, visceral Laparoscopic techniques, and conventional visceral anastomosis techniques as well as courses in vascular and orthopedic surgery. A valid und reliable objective assessment tool was developed in Canada and currently used widely by residency training programs in the USA and Canada to evaluate the efficacy of technical skill development outside the operating room in a bench setting. This tool is called, the Objective Structured Assessment of Technical Skill (OSATS). The aim of our study is to demonstrate the improvement of surgical skills through the participation in a selected training module using a validated international assessment tool (OSATS). Materials and Methods: The visceral anastomosis course which includes five training modules on animal models and takes place over two days was selected for evaluation. Performance of the participants in one module (end-to-end Bowel anastomosis) was measured by qualified surgeons using a task specific Checklist at the beginning and at the end of the course with instructor to participant ratio 1 to 10. The improvement in OSATS scores pre-post the course was assessed using paired T-Test. Participants were asked to perform a baseline bowel anastomosis independent of the course and their scores was analyzed as a possible correlation factor with final OSATS scores. Demographic data of the Participants as well as subjective evaluation forms were collected. Results: A total of 38 surgical residents completed the 2-day visceral anastomosis course. The mean age was 34 ± 6 years. Fifty-eight Percent were males. Most of the participants were in their 4th and 5th years of residency training. 66% reported performing ≤ 10 Bowel Anastomosis since the beginning of their surgical training. Eight participants (21%) were able to perform an end-to-end Bowel Anastomosis independent of the course and scored a mean of 15 ± 3 in OSATS. OSATS scores improved significantly after completing the course (p...