Criterion-based (proficiency) training to improve surgical performance

Area of Science:

• Otorhinolaryngology
• Surgical Education
• Medical Simulation

Background:

• Current otorhinolaryngology residency training relies on fixed procedural repetition.
• The effectiveness of simulator-based training to achieve proficiency in Endoscopic Sinus Surgery (ESS) requires investigation.

Purpose of the Study:

• To compare the operating room performance of residents trained to proficiency on an ESS simulator versus those trained by traditional methods.

Main Methods:

• A prospective cohort study involving junior residents at two academic medical centers.
• Experimental group trained to proficiency on an ESS simulator; control group performed a fixed number of procedures.
• Performance assessed via videotaped standardized surgeries evaluated by expert panels.

Main Results:

• Residents trained to proficiency on the simulator showed improved navigation skills compared to controls.
• No significant difference in final performance based on the number of simulator trials to achieve proficiency.
• Simulator-trained residents performed comparably to attending surgeons in certain metrics.

Conclusions:

• Achieving proficiency via simulator training enhances resident technical skills in ESS.
• Simulator-based proficiency training yields operative performance at least equal to conventional surgical training.
• Individualized proficiency benchmarks on simulators are effective regardless of inherent skill variation.