Evaluating Surgery Resident Technical Skills: Intestinal Anastomosis in a Porcine Model

Area of Science:

• Surgical Education
• Gastrointestinal Surgery
• Medical Simulation

Background:

• Changing surgical training landscapes necessitate efficient methods for resident education.
• Ensuring surgical quality requires effective training in fundamental procedures like intestinal anastomosis.
• Technological advancements and work hour restrictions impact traditional surgical training paradigms.

Purpose of the Study:

• To evaluate the efficacy of a porcine skills laboratory for teaching handsewn intestinal anastomoses.
• To assess resident performance improvement using validated subjective and novel objective measurements.
• To compare the learning curves of junior versus senior surgery residents.

Main Methods:

• Prospective study involving 28 general surgery residents over four months.
• Standardized two-layer, handsewn, end-to-end small intestine anastomosis performed in a live porcine model (pretest and posttest).
• Intervention included an instructional module and skills laboratory session led by attending surgeons, followed by blinded video evaluations using Objective Structured Assessment of Technical Skills (OSATS).

Main Results:

• Significant improvement in OSATS scores from pretest (11.16) to posttest (24.59) (P < 0.001) across all residents.
• Both junior and senior residents demonstrated statistically significant improvements in technical skills (P < 0.001).
• Significant reduction in Lembert sutures used (2.36 to 0.93, P = 0.001) and time to completion (31.28 to 28.2 minutes, P = 0.046).

Conclusions:

• A structured educational intervention using a live porcine model significantly enhances residents' technical skills in intestinal anastomosis.
• The skills laboratory provides a valuable platform for surgical skill acquisition and improvement.
• This training method is effective for both junior and senior residents, contributing to improved surgical quality.