Resident performance in simulation module is associated with operating room performance for laparoscopic...

Area of Science:

• Medical Education
• Surgical Simulation
• Laparoscopic Surgery

Background:

• Surgical simulation is crucial for training, but its effectiveness in transferring skills to the operating room (OR) remains unclear.
• This study investigates the link between resident performance in a laparoscopic cholecystectomy (LC) simulation module and their subsequent OR performance.

Purpose of the Study:

• To explore the association between resident simulation performance and actual operating room (OR) performance in laparoscopic cholecystectomy (LC).
• To determine if simulation-based assessments reliably predict surgical proficiency in a clinical setting.

Main Methods:

• General surgery residents completed an LC virtual reality simulation module.
• Performance was assessed using Global Operative Assessment of Laparoscopic Skills (GOALS), Objective Structured Assessment of Technical Skills (OSATS), and a LC-specific form (LC-SIM).
• Operating room (OR) performance was evaluated using the Surgical Training and Assessment Tool (STAT).

Main Results:

• Higher LC-SIM incision/port placement scores correlated with better tissue handling and economy of motion in the OR.
• However, higher OSATS time/motion and overall performance scores were associated with worse tissue handling, economy of motion, and overall grades in the OR.
• Higher GOALS depth perception scores were linked to worse tissue handling.

Conclusions:

• Significant positive and negative associations exist between simulation and OR performance, particularly concerning tissue handling and economy of motion.
• Simulation performance may not reliably predict OR performance, potentially due to differences in the learning environment and assessment metrics.
• Observed discrepancies might reflect resident caution in the OR, leading to longer operative times misinterpreted as poorer efficiency.