Impact of fundamentals of laparoscopic surgery training during medical school on performance by first year surgical residents.

BACKGROUND

Fundamentals of Laparoscopic Surgery (FLS) certification is a high stakes examination. The best training methods to enable successful certification are undetermined. We hypothesized that first year surgical residents (R01s) who had been pretrained as medical students would perform better during skills training than previously un-trained R01s.

METHODS

This is an IRB-approved, retrospective review of FLS training data generated from a single surgical skills laboratory from July 2007 through June 2010. During the study period, there were 24 R01s with no previous FLS exposure (NOVICE group) and seven R01s who had undergone FLS task training while medical students (MS4 group). All R01s practiced the FLS skill tasks weekly for portions of the training sessions with informal feedback and teaching. Performance goals were proposed for each task based on local and national proficiency figures. The performance outcome measure was task completion time (TCT). Pretraining performance was designated iTCT and post-training fTCT.

RESULTS

The MS4 group began with iTCTs for all four tasks that were significantly lower than the NOVICE iTCTs. At completion of the 16-wk training period, the MS4 group continued to demonstrate mean fTCTs that were lower for all four FLS skill tasks but only significantly for PEG, CIRCLE, and INTRA skill tasks. Both NOVICE and MS4 groups showed significant improvement for all four skill tasks (P < 0.05).

CONCLUSIONS

In the current milieu of work-hour limitations, the integration of FLS skill training into medical school curriculum provided a durable advantage to the pretrained R01s, which was associated with higher levels of final performance.