An exploratory project to develop an effective educational system to teach mastery of assistant laparoscopic gynecologic surgery skills.

Abstract

In laparoscopic surgery, the cooperation of the first assistant surgeon is essential for the creation and maintenance of an appropriate and safe surgical field. The aim of this study is a validation of the impact of our educational system for first assistant laparoscopic surgeon residency in a single university-affiliated teaching hospital. Five residents were recruited for this study. We created a slide-set as an educational tool using Microsoft's PowerPoint that was in line with our surgical procedure to master the assistant skills of laparoscopic gynecologic surgery. Immediately after surgery, the attending doctor and residents reviewed videos of the first assistant's operative procedures. This study evaluated the effect of our educational checklist against the transition of evaluation scores before and after training in two groups of residents, those with minimal experience (Group 1) or with high experience (Group 2). Before receiving our training tool, there was an expected significant difference in the review scores of the two experience groups (29.1 ± 3.1 vs 48.7 ± 3.9, P=.01). After our modified training, the inexperienced residents of Group 1 received review scores comparable to or higher than those of the experienced residents of Group 2 (81.9 ± 5.9 vs 70.4 ± 7.5, P=.23). As they assisted with more surgeries, the concordance between the resident's self-assessment and the attending doctor's assessment scores significantly increased (P < .001). Our educational system for first assistant surgeons is effective for new residents, as it proved capable of imparting them with many of the same skill sets as much more experienced attending doctors.