Abstract
To create two valid and reliable assessment tools; utilize them to determine if use of the Laparoscopic Hysterectomy Trainer (LHT-Simpraxis®) by OB/GYN residents improves their cognitive surgical competency. Two phased, multicentre, prospective, randomized, controlled study at five university-affiliated OB/GYN residency programs. Phase One: Development and validation of two interactive on-line tests (A,B) that assess knowledge of laparoscopic hysterectomy (LH). Tests were administered to upper level residents and faculty (RF) using crossover design. Phase Two: Postgraduate year one OB/GYN residents (PGY1) were randomized into Control (C) or Intervention (I) groups. Both groups completed on-line pre-test and standard site-specific resident curriculum. Intervention group additionally utilized the LHT-Simpraxis®. After two months both groups completed post-test. Phase One: Sixty RF completed tests A,B. Forty took A first; twenty took B first. There was no significant difference in scores between the 2 versions, establishing test reliability (linear regression P = 0.565; t-test P = 0.366). RF test A scores (77%) were significantly higher than PGY1 score (47%), (P < 0.001, 95% CL 141.53, 180.13), establishing construct validity. Phase Two: There was no significant difference in pre-test scores between groups, (C = 49%, I = 43%; P = 0.089). Intervention group scored significantly better on post-test, C = 59%, I = 69% (t-test: P < 0.001, 95% Cl -108.8, -48.4). There was a significant difference in post- vs. pre-test scores (P < 0.0002, 95% CI -80.10, -26.55). Two reliable and valid on-line tests were developed that can be utilized independently to assess cognitive surgical knowledge of LH. Use of the LHT-Simpraxis® significantly improved PGY1 residents' surgical knowledge of LH.
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