Saseem Poudel1, Yo Kurashima, MD, PhD1, Kimitaka Tanaka, MD, PhD1, Hiroshi Kawase, MD, PhD1, Yoshihiro Murakami, MD, PhD2, Yo Kawarada, MD, PhD3, Yoichi Ito, PhD4, Fumitaka Nakamura, MD, PhD5, Toshiaki Shichinohe, MD, PhD1, Satoshi Hirano, MD, PhD1. 1Hokkaido University, Graduate School of Medicine, Department of Gastroenterological Surgery II, 2Asahikawa City General Hospital, Department of Surgery, 3KKR Tonan Hospital, Department of Surgery, 4Hokkaido University Department of Biostatistic, 5Teine Keijinkai Hospital, Department of Surgery
Background: In recent years, various studies have firmly established simulation training to be superior to traditional training methods, however it is yet to be fully incorporated into the surgical residency training in outside of North America. In Japan, distribution residents in wider variety of hospital, lack of finance and time for training has limited incorporation of simulation into residency training. There is a need for cost effective systematic training system for novice surgeons. We had previously developed and validated the TAPP checklist, to evaluate the recorded performance of transabdominal preperitoneal (TAPP) repair and developed an educational system which included the didactic materials based on the TAPP checklist and incorporated remote evaluation and feedback system.
Objective: To evaluate the educational impact of the TAPP education system on novice surgeons.
Method: Residents and surgeons from participating hospitals, who had performed 0 or 1 TAPP procedure were recruited for this study from April 2015 to March 2016. The participants were randomly assigned to Intervention Group (IG) who trained using this new educational tool and Control Group (CG) who trained using the conventional system. They were required to send the surgical videos of their TAPP cases. These videos were rated by blinded raters. All the participants performed their first case before randomization as control. The participants scoring more than 20 (full marks 24) in their first case were excluded from the study. IG then received the Educational tools and ratings and feedback from their surgery. They were also encouraged to practice intracorporeal suturing in the drybox. They were allowed to perform further cases after they met the predetermined operator criteria. The improvement of the TAPP checklist scores of both groups were compared from case 1 to 3. We also compared their scores of their 3rd case.
Result: The eighteen participants from 9 institutes were recruited for this study. 7 participants in IG and 5 participants in CG completed the study and were included in the final analysis. There was no difference between the backgrounds of the participants. From their first case, the participants in IG and CG had improved their scores by 8.7 (SD5.0) and 1.0 (SD3.2) respectively (p=0.01). The IG score of 3rd case by 21.3 (SD2.0) was significantly higher than that of CG score by 16.4 (SD 4.7) (p=0.04).
Conclusion: The newly developed TAPP educational system was effective in improving the TAPP performance of novice surgeons.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78832
Program Number: P316
Presentation Session: Poster (Non CME)
Presentation Type: Poster
