• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

A Simulator-Based Resident Curriculum for Laparoscopic Common Bile Duct Exploration Resulting in Increased Clinical Utilization of the Procedure

Ezra N Teitelbaum, MD1, Nathaniel J Soper, MD1, Rym El Khoury, MD1, Ran B Luo, MD2, Benjamin Schwab, MD1, Byron F Santos, MD3, Alexander P Nagle, MD1, Eric S Hungness, MD1. 1Northwestern University, 2University of California at San Diego, 3Dartmouth-Hitchcock Medical Center

Introduction: Despite demonstrated clinical advantages, laparoscopic common bile duct exploration (LCBDE) remains an underutilized operation for choledocholithiasis, with only 7% of such patients in the United States treated with LCBDE at the time of cholecystectomy, as opposed to 93% with both ERCP and laparoscopic cholecystectomy. To address this, we implemented a previously-validated simulator-based resident curriculum to teach LCBDE. In this study, we examined the impact of this curriculum on clinical utilization of LCBDE at our institution.

Methods: Senior residents at a single institution underwent a two-month LCBDE curriculum involving reading and video didactics, and training on a LCBDE-specific simulator using a ‘deliberate practice’ learning model.  Residents completed pre and post-curriculum tests, with the passing score determined using an Angoff method. The curriculum occurred in three phases over three academic years: in the first stage (2012-13) residents were trained individually by a fellow preceptor, in the second (2013-4) residents were paired with an OR nurse and trained as a team, and in the third (2014-15) chief residents who had passed the curriculum during the prior phases served as trainers for additional curriculum-naïve PGY-4 resident and OR nurse teams. Clinical volume of LCBDE before and after curriculum implementation was determined using department billing data.

Results: 20 residents and 10 nurses underwent the curriculum. During the first phase, 10 residents trained individually. All 10 failed the pre-test and passed the post-test. During the second phase, 7 resident-nurse teams were trained. 6 teams failed the pre-test and all 7 passed the post-test. During the third phase, chief residents who had passed the curriculum trained 3 additional resident-nurse teams. All 3 failed the pre-test and all passed the post-test. During the 6 academic years (2006-12) preceding curriculum implementation, a mean of 1.7 (range 0 to 4) LCBDEs per year were performed at our institution, as compared to a mean of 8.3 (range 5 to 13) per year after implementation (2012-present) (p < .05). All LCBDEs in the post-curriculum period were performed by residents who had undergone the curriculum, and 58% of these cases were performed by attending surgeons who did not have prior clinical experience with LCBDE. Over the study period, the number of laparoscopic cholecystectomies performed yearly did not change significantly.

Conclusion: A resident curriculum for LCBDE resulted in increased clinical utilization of the procedure. Further study is needed to determine the effect of this curriculum on clinical outcomes for patients with choledocholithiasis.

107

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2016 abstract archive

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
sagesweb@sages.org
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons