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A Competency-based Laparoscopic Cholecystectomy Curriculum Significantly Improves General Surgery Residents'

Elizabeth M Huffman1, Jennifer N Choi, John R Martin

  • 1Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.

Annals of Surgery
|April 29, 2021
PubMed
Summary
This summary is machine-generated.

Competency-based education (CBE) improved laparoscopic cholecystectomy (LC) skills for general surgery residents, matching experienced surgeons and reducing performance variability. This supports wider adoption of CBE in surgical training programs.

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Area of Science:

  • Surgical Education
  • Medical Simulation
  • Competency-Based Education

Background:

  • Operative skill variability impacts patient outcomes in general surgery.
  • Competency-based education (CBE) offers a framework to standardize skill acquisition.
  • Laparoscopic cholecystectomy (LC) is a common procedure where skill variability is a concern.

Purpose of the Study:

  • To assess the feasibility of implementing a CBE curriculum for general surgery residents.
  • To evaluate the effectiveness of CBE in improving resident operative skills, specifically in LC.
  • To determine if CBE reduces performance variability among surgical residents.

Main Methods:

  • PGY-2 residents underwent a structured CBE LC curriculum with simulation and operative performance assessments.
  • Performance metrics and intraoperative ratings were compared to baseline and historical PGY-3 controls.
  • Statistical analysis included Wilcoxon rank-sum and Levene robust tests to compare performance and variability.

Main Results:

  • Residents significantly improved simulated and operative LC performance after the CBE curriculum.
  • Trained PGY-2 residents achieved performance levels comparable to experienced PGY-3 residents.
  • A significant decrease in performance variability was observed in the PGY-2 group post-CBE (P = 0.04).

Conclusions:

  • Completion of a CBE rotation significantly enhanced laparoscopic cholecystectomy performance for PGY-2 residents.
  • CBE training resulted in performance levels equivalent to more senior residents with reduced variability.
  • These findings advocate for the broader implementation of competency-based education in surgical residency programs.