Development of a standardized training course for laparoscopic procedures using a Delphi methodology

M.s. Bethlehem, MD, M.j. van Det, MD, PhD, H.o. ten Cate Hoedemaker, MD, N.j.g.m. Veeger, PhD, J.p.e.n. Pierie, Prof. Medical Center Leeuwarden, University Medical Center Groningen.

Background: Content, evaluation and certification of laparoscopic skills- and procedure training lack uniformity among different hospitals in the Netherlands. Within the process of developing a new regional laparoscopic training curriculum, a uniform and transferrable curriculum was constructed for a series of laparoscopic procedures.

The aim of this study was to determine regional expert consensus regarding the key steps for laparoscopic appendectomy and cholecystectomy using a Delphi methodology. 

Methods: Lists of suggested key steps for laparoscopic appendectomy and cholecystectomy were created using surgical textbooks, available guidelines and local practice. Twenty-two experts, working for teaching hospitals throughout the region, were asked to rate the suggested key steps for both procedures on a Likert scale from 1-5. Consensus was reached with Cronbach’s alpha ≥ 0.90.

Results: Out of the twenty-two experts, twenty-one completed and returned the survey (95%). Data analysis already showed consensus after the first round of Delphi on the key steps for laparoscopic appendectomy (Crohnbach’s alpha 0.92) and laparoscopic cholecystectomy (Crohnbach’s alpha 0.90). After the second round, 15 proposed key steps for laparoscopic appendectomy and 30 proposed key steps for laparoscopic cholecystectomy were rated as important (≥ 4 by at least 80% of the expert panel). These key steps were used for the further development of the training curriculum.

Conclusion: By utilizing the Delphi methodology, regional consensus was reached on the key steps for laparoscopic appendectomy and cholecystectomy. These key steps are going to be used for standardized training- and evaluation purposes in a new regional laparoscopic curriculum.

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