Integration of Didactics and Simulation to Teach Proper Laparoscopic Positioning [104

Abstract

INTRODUCTION: Proper patient positioning is paramount to both patient safety and surgical efficacy. In laparoscopic surgery, the patient is subjected to steep Trendelenburg positioning and prolonged surgical times. These are significant risk factors in positioning-related nerve injuries. We developed a workshop integrating a classic didactic curriculum with a simulation component for residents to experience first hand the importance of proper laparoscopic positioning. METHODS: A 10-question preintervention assessment on “Laparoscopic positioning and nerve injury” based on a comprehensive review in the Journal of Minimally Invasive Gynecology was administered to 20 obstetrics and gynecology residents. The residents then participated in an interactive peer-led didactic course reviewing upper and lower extremity nerve injuries common in laparoscopic surgery. The residents were individually assessed on their technique by an attending physician and their peers. At completion of the workshop, the same 10-question quiz was administered to assess retention of the material. RESULTS: The average pretest score was 67.9% with the highest average score in the postgraduate year 4 level (73.3%) and lowest average score in the postgraduate year 1 level (36.7%). The average posttest score was 90.6% with the highest average score in the postgraduate year 3 level (92.5%) and lowest average score in the postgraduate year 1 level (88.3%). CONCLUSION: This study demonstrates a benefit in implementing an integrated didactic and simulation workshop in laparoscopic positioning during residency training. This illustrates the benefits of peer-to-peer instruction in didactic education and the use of a patient-centered simulation model to enhance resident education.