Tuesday, April 24, 2018

Laparoscopic assessment tool in Saudi commission Obstetrics and Gynecology residents

Anwar Moria
Dr. Soliman Fakeeh Hospital

Background: Laparoscopic gynecological surgery has become the standard of care for most gynecological procedures performed nowadays. The learning curve for Laparoscopic surgery is steep and residents need to participate in numerous surgeries to acquire sufficient skills. Training programs faces time limitation in direct patient-based clinical training, thereby custom built trainers in addition to virtual programs are used to provide training to residents. Box trainers have shown to be an excellent model for training and assessment of residents in laparoscopic skills.

Methods: We developed a laparoscopic assessment tool utilizing the Objective Structured Assessment of Technical Skills (OSATS) and the Laparoscopic Skills Testing and Training (LASTT) box trainer model. Three test were performed on 14 residents in the Saudi commission of Obstetrics and Gynecology. the residents were grouped based on their respective year of training and number of laparoscopic procedures performed. The test was evaluated by 6 raters randomly selected.

Results: The inter rater reliability (IRR) score for this study was 0.8, average score of residents from PGY4-PGY1 were 4.0, 2.6, 2.5, 1.6 respectively. Residents scores were higher among groups with more procedure performed. Some residents with less procedures performed obtained better scores compared to some residents with more procedures.

Discussion: Laparoscopic assessment tools using laparoscopic box trainers are a useful tool in reflecting the skill growth among residents. Attention is needed to support the residents milestone development and competencies in laparoscopic training. The number of performed surgeries and log books alone are not an indicator for individuals competency. More research is required to determine an accurate laparoscopic assessment tool and competency scoring system.