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THE INTERNATIONAL LAPAROSCOPIC ADVANCEMENT PROGRAM: EVALUATING THE SURGICAL EDUCATION ENVIRONMENT IN MEXICO

Lauren M Baumann, MHS, MD1, Rodrigo Prieto, MD2, Eduardo Moreno-Paquentin, MD3, Raymond R Price4, Jeffrey Hazey, MD5, Katherine A Barsness, MD1. 1Ann & Robert H. Lurie Children’s Hospital, 2University of Guadalajara, 3Centro Médico ABC, 4University of Utah, 5Ohio State University Medical Center

Introduction: The International Laparoscopic Advancement Program (iLAP) is a collaborative initiative between the SAGES Global Affairs Committee and the Asociación Mexicana de Cirugía General, that aims to build educational infrastructure and standardize training and education in laparoscopy throughout 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 SBE course for local trainees. The purposes of this study were to understand the existing educational environment at a single institution in Mexico and measure the changes in perceptions, attitudes, and engagement in surgical education after an intensive training course.

Methods and Procedures: All 13 faculty and 13 of 25 general surgery resident participants completed a survey that contained 7 items designed to assess the existing educational environment at a large, public hospital in Mexico.  Using a 5-point Likert scale, residents self-rated the quality of faculty feedback and the learning environment within their institution (1=strongly disagree, 3=neutral, 5=strongly agree).   Faculty rated their perceptions of the same educational themes.  Upon completion of a faculty-lead simulation course, residents rated the educational environment during the course.  Faculty provided additional qualitative feedback. Descriptive analyses were performed.  IRB-exemption was obtained through Lurie Children’s Hospital.

Results: Discordance existed in perceptions of the existing educational environment.  The greatest disparity between resident and faculty perceptions included “faculty provide sufficient feedback in the operating room” (31% vs. 100%), “faculty promote an active learning environment” (38% vs. 85%), and “residents may ask questions without fear of negative evaluation” (46% vs. 100%).  Faculty and residents agreed with “residents are sometimes afraid to speak up in the operating room for fear of retaliation” (46% each).  Post-course evaluations (n=19) revealed universal improvement in all educational themes during the simulation course. Qualitative feedback revealed most faculty plan to incorporate open communication and safe learning into their practice.  Residents were equally positive, with 100% optimistic that they will see changes within the educational environment.

Conclusions: Significant discordance exists in resident and faculty perceptions of the educational environment at a large teaching hospital in Guadalajara, Mexico.  After participation in the iLAP course, residents noted demonstrable change in the faculty approach to education and feedback, and both faculty and residents expressed optimism for increased engagement in education.  The immediate successes of the iLAP initiative should be followed over time, as the ultimate measure of success is sustainability and scalability throughout Mexico.


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

Abstract ID: 88291

Program Number: P304

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

Post Views: 31

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