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Effects of two training curricula on basic laparoscopic skills and surgical performance among veterinarians

Boel A. FranssonDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.

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Claude A. RagleDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.

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Margaret E. BryanDepartment of Statistics, College of Sciences, Washington State University, Pullman, WA 99164.

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Abstract

Objective—To compare laparoscopic skills among veterinarians before and after undertaking 1 of 2 programs of simulation training.

Design—Evaluation study.

Sample Population—17 veterinarians at 1 institution.

Procedures—Basic skills were tested by use of the McGill inanimate system for training and evaluation of laparoscopic skills (MISTELS). Surgical performance was assessed through an objective structured assessment of technical skills (OSATS). Both tests were performed prior to and after a 12-session training program, consisting of MISTELS exercises (curriculum A) or a variety of exercises (curriculum B).

Results—Curriculum B led to improvement of scores obtained with both the MISTELS and the OSATS. Curriculum A did not result in higher scores obtained with the MISTELS, compared with curriculum B. Curriculum A did not lead to an improvement of scores obtained with the OSATS. Participant-perceived value of the training program was correlated positively with the improvement of scores for MISTELS suturing tasks and scores obtained with the OSATS. Time spent in clinical laparoscopic surgery and curriculum B training were both positively correlated with the post-training OSATS scores but not with post-training MISTELS scores. Conversely, simulation training time correlated with an increase in MISTELS scores but not OSATS scores.

Conclusions and Clinical Relevance—MISTELS training resulted in significant improvement of basic laparoscopic skills but not in the assessment used for surgical performance. This may have been due to the small number of study participants, the assessment tool, or the method of training. A varied curriculum may be advantageous when training veterinarians for clinical laparoscopic practice.

Abstract

Objective—To compare laparoscopic skills among veterinarians before and after undertaking 1 of 2 programs of simulation training.

Design—Evaluation study.

Sample Population—17 veterinarians at 1 institution.

Procedures—Basic skills were tested by use of the McGill inanimate system for training and evaluation of laparoscopic skills (MISTELS). Surgical performance was assessed through an objective structured assessment of technical skills (OSATS). Both tests were performed prior to and after a 12-session training program, consisting of MISTELS exercises (curriculum A) or a variety of exercises (curriculum B).

Results—Curriculum B led to improvement of scores obtained with both the MISTELS and the OSATS. Curriculum A did not result in higher scores obtained with the MISTELS, compared with curriculum B. Curriculum A did not lead to an improvement of scores obtained with the OSATS. Participant-perceived value of the training program was correlated positively with the improvement of scores for MISTELS suturing tasks and scores obtained with the OSATS. Time spent in clinical laparoscopic surgery and curriculum B training were both positively correlated with the post-training OSATS scores but not with post-training MISTELS scores. Conversely, simulation training time correlated with an increase in MISTELS scores but not OSATS scores.

Conclusions and Clinical Relevance—MISTELS training resulted in significant improvement of basic laparoscopic skills but not in the assessment used for surgical performance. This may have been due to the small number of study participants, the assessment tool, or the method of training. A varied curriculum may be advantageous when training veterinarians for clinical laparoscopic practice.

Contributor Notes

Ms. Bryan's present address is Department of Statistics, College of Arts and Sciences, University of Missouri, Columbia, MI 65211.

Supported by the Morris Animal Foundation.

Sawbones Pacific Research Laboratories donated the Mayo Endoscopy Simulated Image canine abdominal models used in this study.

Presented in part at the Veterinary Endoscopy Society Annual Meeting, Breckenridge, Colo, March 2010, and at the Society for Veterinary Soft Tissue Surgeons, Steamboat Springs, Colo, June 2010.

The authors thank Tiffany Patton and Krystina Vanderhoff for technical assistance and Krystina Vanderhoff for assistance with data obtained from clinical practice.

Address correspondence to Dr. Fransson (bfransso@vetmed.wsu.edu).