Abstract
to develop a training program in minimally invasive surgery, based on simulation and with an emphasis on the acquisition of laparoscopic competences. this was a prospective, observational study carried out at a university hospital in Belo Horizonte, Brazil, between April 2020 and January 2021. We recruited residents of surgical specialties for structured, progressive training according to instructional principles to promote learning, such as motivation, activation, demonstration, application, and integration. We filmed the skill tests at the program's beginning, middle, and end, which were then anonymously evaluated by a surgical education expert. Individual performances were scored using the global assessment tools "GOALS" and "specific checklist for suture". At the end, all participants received individual feedback and completed a questionnaire to assess the impact of training on the Kirkpatrick model. 43 residents completed the program. The evolution of performances was evident and grew between tests. The average achievements were 29% in the initial test, 43% in the intermediate test, and 88% in the final test, with significant differences between all mean scores, with H=97.59, GL=2, p<0.0001. The program evaluation and learning perceptions were excellent, but only 10.7% of residents felt fully capable of performing unsupervised, low-complexity laparoscopic surgery at the end of training. the training program developed in this study proved to be feasible and promising as a strategy for teaching laparoscopic surgery.
Highlights
A t the end of 2019, coronavirus disease a new infectious disease called 19 (COVID-19) was responsible for the onset of a pandemic that affected and continues to affect health systems worldwide in different ways.There was a sudden increase in the demand for care and hospital beds, which overloaded these systems[1]
In moments of greatest upsurge of the pandemic, world health authorities recommended that elective operations be avoided, to reduce the care burden caused by the new coronavirus by reducing the exposure of medical teams and patients to potential contamination[2,3]
Since the volume of operations in hospitals was drastically reduced, surgical education based on the Halstedian model was compromised[7]
Summary
A t the end of 2019, coronavirus disease a new infectious disease called 19 (COVID-19) was responsible for the onset of a pandemic that affected and continues to affect health systems worldwide in different ways.There was a sudden increase in the demand for care and hospital beds, which overloaded these systems[1]. In moments of greatest upsurge of the pandemic, world health authorities recommended that elective operations be avoided, to reduce the care burden caused by the new coronavirus by reducing the exposure of medical teams and patients to potential contamination[2,3]. Such recommendations directly impacted the teaching and training of new medical professionals, especially those inserted in medical residency programs in surgical specialties[4-6]. Since the volume of operations in hospitals was drastically reduced, surgical education based on the Halstedian model was compromised[7] In this pandemic scenario, together with the steep learning curve in the acquisition of operative skills in laparoscopy, training of residents outside the operating room was even more recommended[8]. Teaching through simulation models develops familiarity with the handling of laparoscopic instruments, as well as cognitive and technical competences in minimally invasive operations[9]
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