Effect of instituting a laparoscopic curriculum on knowledge and retention of knowledge of OBGYN residents

Camila Caroline De Amorim Paiva, MD, Nancy Z Tang, MD, Pedram Bral, MD. Maimonides Medical Center

Numerous obstacles exist for learning the principles and technical skills necessary for minimally invasive operations. The traditional teaching model is based solely in guiding the residents in the operating room. However, skill is defined as a well-organized knowledge base in long-term memory, developed with experience and training for the performance of a targeted task. Hence, we aimed to assess the effect of a structured laparoscopic curriculum on resident knowledge, as well as on retention of knowledge of the fundamental principles of laparoscopy.

This is a prospective interventional study, performed at an academic community hospital. Initially, we administered a pre-intervention test to 20 residents in the OBGYN department. The junior residents (n=10) were brought through our structured laparoscopic curriculum over the course of the academic year, while the senior residents continued in the traditional teaching model (n=10). The curriculum consists of classroom-based lectures in addition to operating room exposure. The lectures pertained to the fundamental principles of laparoscopy, we included patient positioning and related nerve injuries, electrosurgery, laparoscopic equipment, physiological considerations, and laparoscopic complications. After the course of the academic year, all the residents were administered a post-intervention exam. In sequence, 5 months later, the junior residents were administered the same exam. Test scores were compared, averages calculated, and t-test applied.

In the first stage, the average pretest score for junior residents was 35%, and for senior residents was 42.14%. On the other hand, the average posttest score for junior residents was 75.71%, and for senior residents was 48.70%. This means, in absolute numbers, that the junior residents group improved 40.71%, while the senior residents improved 6.42%, which is a statistically significant difference (t-value=4.5; p<0.01). In the second phase, 5 months after the course of the academic year, the average score for junior residents was 66.42%. Compared to their initial posttest score (75.71%), there was no statistically significant difference (t-value=1.5, p=0.14).

Introducing a laparoscopic curriculum to a residency program has a significant impact on improving resident knowledge of the fundamental principles of laparoscopy, as well as in retaining the acquired knowledge. Future studies are underway to evaluate the effect of a structured didactic curriculum on resident operating room performance.

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