Defining the key skills required to perform advanced laparoscopic procedures: a qualitative descriptive study

Area of Science:

• Surgical Education
• Medical Simulation
• Laparoscopic Surgery

Background:

• Current laparoscopic simulation programs inadequately address the needs of trainees and surgeons learning advanced laparoscopic procedures (ALP).
• Program directors report a gap between existing simulation capabilities and the requirements for advanced surgical training.

Purpose of the Study:

• To identify and define the critical skills necessary for performing advanced laparoscopic procedures (ALP).
• To establish a foundational understanding for developing a comprehensive ALP simulation training program.

Main Methods:

• Conducted semi-structured interviews with attending surgeons, fellows, and senior residents across general surgery, gynaecology, and urology.
• Utilized an iterative question development process involving literature review, expert consultation, and qualitative research expertise.
• Performed inductive thematic analysis on interview data from 25 participants at 9 institutions in Canada and the USA.

Main Results:

• Identified 21 essential skills for performing ALP.
• Faculty and trainees commonly cited suturing, dissection, and procedural expertise as key skills.
• Discrepancies were noted in the perceived importance of skills like retraction/exposure (faculty-emphasized) versus trocar positioning and patient factors (trainee-emphasized).

Conclusions:

• This research delineates crucial skills for advanced laparoscopic surgery (ALP) training.
• The findings provide essential components for creating an effective ALP simulation program to meet current educational needs.