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The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

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Enhancing Intraoperative Cholangiography Interpretation Skills: A Perceptual Learning Approach for Surgical

Steven Patrick Wightkin¹, Jose Velasco², Scott Schimpke³

¹College of Health Sciences, Rush University Medical Center, Chicago, Illinois.

Journal of Surgical Education

|July 3, 2024

Summary

A new perceptual learning (PL) training module significantly improved surgical residents' ability to interpret intraoperative cholangiography (IOC) images and make clinical decisions. This training enhanced accuracy and confidence while reducing interpretation time.

Keywords:

intraoperative cholangiography laparoscopic cholecystectomy medical education perceptual learning resident confidence simulation

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Area of Science:

Medical Education
Surgical Training
Medical Imaging Interpretation

Background:

Laparoscopic cholecystectomy carries risks of serious complications.
Intraoperative cholangiography (IOC) aids in biliary tree anatomy clarification and common bile duct injury detection.
Mastering IOC interpretation is challenging and lacks a formal curriculum for surgical residents.

Purpose of the Study:

To develop and evaluate a perceptual learning (PL)-based training module for surgical residents.
To improve residents' skills in interpreting intraoperative cholangiography (IOC) images and clinical recommendations.

Main Methods:

Two-phase study involving surgical residents at Rush University Medical College.
Phase 1: Pre/post assessment of an online PL-based IOC interpretation module measuring accuracy, response time, and confidence.
Phase 2: Evaluation of combining simulator-based training with the online module on the same metrics.

Main Results:

Phase 1: Significant improvements in clinical management accuracy (68.1% to 82.3%) and reduced response time (25s to 17s) post-training (p < 0.001).
Majority of residents (95.7%) found the online module helpful, with increased confidence in IOC interpretation.
Phase 2: Combined training showed significant confidence improvements and a more substantial reduction in response time compared to controls.

Conclusions:

The PL-based online module effectively enhanced surgical residents' IOC interpretation skills, accuracy, confidence, and efficiency.
Integrating simulator-based training further bolstered these improvements.
This approach offers a potential solution to the absence of formal IOC interpretation curricula in surgical education.