Cuan M Harrington, Patrick Dicker, Oscar Traynor, Dara Kavanagh. Royal College of Surgeons in Ireland
Background: Minimally invasive surgery poses a unique learning curve due to the requirement for non-intuitive psychomotor skills. Programmes such as the Fundamentals of Laparoscopic Surgery (FLS) provide mandatory training and certification for many residents. However, predictors of FLS performance and retention remain to be described. This single-centre observational study aimed to assess for factors predicting the acquisition and retention of FLS performance amongst a surgically naïve cohort.
Methods: Laparoscopically naïve individuals were recruited consecutively from preclinical years of a medical university. Participants completed five visuospatial and psychomotor tests followed by a questionnaire surveying demographics, extracurricular experiences and personality traits. Individuals completed a baseline assessment of the five FLS tasks evaluated by FLS standards. Subsequently, participants attended a 270-minute training-course over week one and two on inanimate box trainers. A post-training assessment was performed in week three to evaluate skill acquisition. Participants were withdrawn from laparoscopic exposure and retested at four one-month intervals to assess skill retention.
Results: Forty-nine eligible participants were enrolled with 35 (71.4%) and 32 (65.3%) completing the acquisition and retention phases respectively. Mean age of participants was 19.3 (±1.2) years with 68.6% female predominance. Participants demonstrated significant improvements in all five tasks during the acquisition (r=-0.26 to -0.62 [p<0.05]) and retention (r=-0.38 to -0.61 [p<0.01]) periods. Significant predictors of skill acquisition involved the aptitudes: card rotations for intracorporeal knot (p=0.027) and combined tasks (p=0.024) and cube comparisons for extracorporeal knot (p=0.040). During the skill retention phase: Card rotations significantly predicted higher skill retention across all five tasks (p<0.05), Cube comparisons for Tasks 1-2, 4-5 (p<0.05), PicSOR for peg-transfer (p=0.017) and grooved pegboard for peg-transfer (p=0.023) and ligating-loop (p=0.038) tasks. Those of sporting, musical instrument, video-gaming background or of higher competitive personalities demonstrated no benefit in skill acquisition.
Conclusions: The visuospatial aptitudes of card rotations and cube comparisons predicted significant FLS performance for skill acquisition and retention. Extracurricular experiences and competitive personality demonstrated no consistent benefits. The application of similar aptitudes within selection criteria to surgical residency should be further considered.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87033
Program Number: P302
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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