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A simulator-based resident curriculum for laparoscopic common bile duct exploration.

Ezra N Teitelbaum1, Nathaniel J Soper1, Byron F Santos1

  • 1Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.

Surgery
|September 21, 2014
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Summary

A new curriculum significantly improved surgical residents' ability to perform laparoscopic common bile duct exploration (LCBDE) using a simulator. Post-curriculum performance showed marked improvement and increased resident confidence in this underused procedure.

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Area of Science:

  • Surgical Education
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Laparoscopic common bile duct exploration (LCBDE) is underutilized in treating choledocholithiasis.
  • Limited exposure during surgical residency contributes to its underuse.
  • A validated procedural simulator was used to implement a novel resident curriculum.

Purpose of the Study:

  • To assess the effectiveness of a resident curriculum designed to improve LCBDE skills.
  • To evaluate resident performance on simulated transcystic and transcholedochal LCBDE before and after curriculum completion.

Main Methods:

  • Senior surgery residents participated in a curriculum focused on deliberate practice with an LCBDE simulator.
  • Residents performed simulated transcystic and transcholedochal LCBDE procedures pre- and post-curriculum.
  • Faculty rated the procedures using the Angoff method to determine passing scores.

Main Results:

  • All 10 residents failed pre-curriculum assessments for both transcystic and transcholedochal LCBDE.
  • Post-curriculum scores significantly improved (P < .01) for both approaches.
  • All residents passed post-curriculum assessments after curriculum completion, with high confidence reported.

Conclusions:

  • The implemented curriculum effectively enhanced surgery residents' proficiency in performing both transcystic and transcholedochal LCBDE on a simulator.
  • This training approach shows promise for increasing the adoption of LCBDE in clinical practice.