Instrument Training for Gynecologic Laparoscopy: A Pilot-Scale Randomized Control Trial to Improve Women's Safety. (October 2016)

• Record Type: Journal Article
• Authors: Lewis, Mark; Islam, Mohammad; Hesson, Ashley; Shellgren, Madeline; Collier, Deborah; Milad, Magdy
• Is Part Of: Obstetrics and gynecology. Volume 128(2016)Supplement
• Publication Date: 2016-10
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000502740.36831.05
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : BACKGROUND: Inadequate technical proficiency in laparoscopy has a substantial negative effect on the safety of laparoscopic gynecologic procedures. Of errors due to lack of technical competence, 58% have been attributed to a deficiency in proper instrument training. METHODS: Forty-two medical trainees were randomized to standard training (ST, N=20) versus enhanced training (ET, N=22). ST participants were shown a 31 seconds instructional video akin to a typical industry briefing, while ET participants viewed a 2:42 seconds video incorporating additional safety information. Participants were then given a ten-question quiz and practice time with the instrument (1 minute for ST, 5 minutes with a tissue sample for ET) followed by a standardized laparoscopic simulator assessment using the instrument on chicken skin models. RESULTS: Quiz scores were significantly higher for ET participants (mean=6.3/10) as compared to ST participants (mean=4.1/10; P <.01). ET participants' psychomotor task times were also significantly faster than ST times (ET mean=113.4 seconds, ST mean=186.7 seconds; P =.02). A significant negative correlation was noted between quiz scores and task times ( P =.01); ie, participants that performed better on the quiz tended to complete the task faster. DISCUSSION: This study demonstrates that a brief, structured training intervention improves both competence and efficiency on a laparoscopic instrument, suggesting that interventions designed to optimize cognitive proficiency and psychomotor skill in situ may decrease morbidity associated with new devices in the operating room.