Criterion-based training with surgical simulators: proficiency of experienced surgeons

Area of Science:

• Medical Education
• Surgical Simulation
• Laparoscopic Surgery

Background:

• Establishing criterion-based skills training is crucial for surgeons.
• Computer-based simulators offer a platform for assessing technical surgical skills.

Purpose of the Study:

• To assess the performance of experienced laparoscopic surgeons on basic technical skills using commercially available simulators.
• To develop proficiency score formulas for evaluating surgical skills in a simulated environment.

Main Methods:

• 17 experienced laparoscopic surgeons practiced on 5 different simulators over 1.5 days.
• Performance data were collected electronically, and proficiency was defined as efficient, error-free performance.
• Demographic and opinion data were also gathered to supplement performance metrics.

Main Results:

• Surgeons exhibited a steep learning curve, with significant improvement in early practice sessions.
• Median scores and performance percentiles (10th, 25th, 75th, 90th) were determined for each module.
• Construct validity was explored by comparing experienced surgeons with less-experienced ones in two modules.

Conclusions:

• A straightforward mathematical method for scoring performance on surgical simulators was established.
• Objective proficiency levels for surgical training courses can now be defined by residency directors and professional organizations.
• Further research is needed to confirm the reliability and validity of surgical simulators as assessment tools, considering the study's small sample size.