Laparoscopy Skills Simulation for the Obstetrics and Gynecology Resident

Operating room experience alone is insufficient for surgical training. In the current era of graduate medical education, work hour restrictions and the expectations of patients and the public limit residents' ability to participate in surgical cases. We aimed to create a laparoscopy curriculum for gynecology residents that teaches the fundamentals of laparoscopy utilizing self-learning modules complemented by skill-focused and faculty-guided laboratories to maximize learning time outside of the operating room.

The curriculum consists of five electronic modules on the basics of laparoscopy. Residents are expected to complete these on their own. In addition, quarterly simulation labs are taught by faculty and allow residents to practice, with guidance, key skills as derived from a previously published laparoscopic surgery skills curriculum. Residents are then evaluated using an objective structured assessment of technical skill comprised of the Global Rating Scale of Operative Performance and time metrics for each skill. We also evaluate resident confidence and satisfaction.

In our initial year, residents' confidence regarding laparoscopy ability and satisfaction in training did demonstrate improvement. With concentrated practice, residents' observed skills also showed advancement. Furthermore, the implementation of the curriculum was feasible with reasonable cost and limited resident and faculty time.

While simulation is well accepted as a modality for teaching surgery, its implementation is often limited due to concerns for time and money. Our experience illustrates that simulation is an effective teaching tool for residents without becoming a burden on a department.