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THE INTERNATIONAL LAPAROSCOPIC ADVANCEMENT PROGRAM: ENHANCING SURGICAL EDUCATION IN MEXICO

Lauren M Baumann, MHS, MD1, Rodrigo Prieto, MD2, Katherine A Barsness, MD1, Raymond R Price, MD3, Jeffrey Hazey, MD4, Eduardo Moreno-Paquentin, MD5. 1Ann & Robert H. Lurie Children’s Hospital, 2University of Guadalajara, 3University of Utah, 4Ohio State University Medical Center, 5Centro Médico ABC

Introduction: SAGES Global Affairs Committee, in partnership with the Asociación Mexicana de Cirugía General, launched the International Laparoscopic Advancement Program (iLAP), that seeks to standardize laparoscopy training and education across Mexico. iLAP participants engage in didactic and hands-on modules in educational theory, laparoscopic techniques, and simulation based education (SBE), and then develop and implement a 1-day surgical simulation course for trainees.  The purposes of this study were to characterize existing minimally invasive surgical (MIS) experience, evaluate baseline educational knowledge and skills, and determine implementation success after an intensive education course.

Methods and Procedures: All13 faculty and 13 of 25 resident participants completed a pre-course survey.  Participants self-reported baseline MIS experience and comfort levels with MIS skills and procedures using a 3-point Likert scale (1=not comfortable, 2=somewhat comfortable, 3=very comfortable), and noted previous surgical education experience.  Following the course, faculty self-rated their comfort level with educational techniques and institutional support for MIS, and provided qualitative course feedback. Resident participants self-rated their comfort level with MIS skills following the faculty-lead simulation course. Descriptive analyses were performed. IRB-exemption was obtained through Lurie Children’s Hospital.

Results: Faculty performed a range of MIS procedures, 100% of participants had experience with cholecystectomy compared to 54% with colectomy and 23% ventral hernia repair. Resident MIS exposure was notably lower.  Most faculty self-reported being “somewhat” or “very comfortable” with MIS skills (range 66-100%), resident comfort level with MIS skills was lower (Table 1). Most common faculty-cited reasons for not performing MIS were lack of comfort with MIS skills (44%) and lack of institutional support for MIS (28%). There was limited baseline experience with educational methods, including no experience with skills assessments and curriculum development. On post-course evaluation,100% of faculty participants self-reported as comfortable performing objective skills assessments and implementing a surgical education curriculum.  Additionally, after participation in the faculty-implemented SBE course, residents self-reported improvement in all MIS skills.

Conclusions: While the majority of surgeons at a large, Mexican teaching hospital are performing laparoscopic surgery, the institutional support for MIS is often lacking, and formalized MIS training is in early development.  The iLAP initiative seeks to drive adoption and sustainability of safe laparoscopic techniques and increase educational awareness and effectiveness.  After instituting a short, intensive surgical education course, participants self-reported improvement in educational and MIS skills.  However, long-term adoption of these educational strategies for sustainable improvements in MIS remains to be assessed.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86370

Program Number: P329

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

122

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