Trainee Performance in Loop Electrosurgical Excision Procedure (LEEP) After Simulation Training.

Area of Science:

• Gynecologic Surgery
• Medical Simulation
• Surgical Education

Background:

• Loop electrosurgical excision procedure (LEEP) is a common gynecologic procedure.
• Effective training is crucial for optimizing LEEP outcomes.
• Simulation-based training offers a controlled environment for skill acquisition.

Purpose of the Study:

• To evaluate the impact of a simulation training program on trainee performance in LEEP procedures.
• To compare specimen quality and operative time before and after simulation training.
• To assess the similarity of trainee outcomes to attending physician performance post-simulation.

Main Methods:

• A simulation training program for LEEP was implemented for gynecology trainees.
• Trainee performance (operating time, specimen quality: margin status, depth, fragmentation) was assessed pre- and post-simulation.
• Data were compared to a 12-month period before training and to attending physician procedures.
• Trainee feedback on the simulation program was collected via surveys.

Main Results:

• Post-simulation, trainee specimens were significantly more likely to be nonfragmented (89.2% vs 55.9%) and have clear margins (72.2% vs 41.9%).
• Median procedure time decreased from 18 to 8 minutes (p < 0.001).
• Specimen quality and operating time for attending physicians remained unchanged; trainee outcomes became similar to attendings post-training.

Conclusions:

• Introduction of LEEP simulation training program led to improved operative time and specimen quality in trainee procedures.
• Simulation training appears to enhance surgical skills effectively, bridging the gap between trainees and experienced physicians.
• Trainees reported positive feedback but noted time constraints as a potential barrier to consistent simulation use.