Educational model for an objective assessment of operative laparoscopic skill

Abstract

ABSTRACTObjective The purpose of this pilot study was to develop an assessment instrument to evaluate the level of skill of laparoscopic surgeons with regard to operative laparoscopy.Subjects A total of 16 doctors working in obstetrics and gynaecology were tested on the Monash University gynaecological laparoscopic pelvi‐trainer. Eight candidates were consultants with 9–28 years of practice in operative laparoscopy, and eight were registrars with up to 6 years of practice in operative laparoscopy. Six consultants and one registrar were from rural Australia.Design Subjects were asked to complete 10 laparoscopic tasks. Nine of these were designed to test manual dexterity skills and the correct use of laparoscopic instruments. One task tested theoretical knowledge of electrosurgery by means of four short‐answer questions. Candidates were marked on the basis of precision and speed. Heart rate measurements were taken 20 min prior to the test, at 5‐min intervals, and at the start and end of each task thereafter.Results The highest pass rate (81.25%) was recorded for task 1, i.e. setting up the endoscopic visualization system. The median time to complete this task was 168 s. No candidate could repair a severed ovarian ligament with an intracorporeal knot within 5 min. No candidate could successfully answer all four electrosurgery questions.Conclusion It is possible to objectively evaluate basic operative skills of laparoscopists by means of well‐structured tasks and marking criteria.