Enhancing Competency in Bariatric-Metabolic Surgery: The Impact of Simulation-Based Training on Surgeons' Experience

Introduction: The learning curve for a laparoscopic Roux-en-Y gastric bypass (LRYGB) requires between 50 and 150 cases to reach competency and over 500 cases to significantly reduce morbidity. Our team has developed and validated a simulation-based training program focused on LRYGB-related skills, but its impact on surgeons' clinical development has not been assessed. Objectives: This study aims to evaluate the perceptions of participants after a bariatric-metabolic surgery simulation-based training course (BSC), exploring potential effects on their surgical exposure and development. Methods: A cohort study was conducted among trainees from the 2018-2023 simulation course who were surveyed to evaluate its impact on surgical experience, proficiency, case exposure, confidence, and clinical outcomes. Results: From 2018 to 2023, 110 trainees completed the BSC, and 27% responded to a follow-up survey. Pre-course, 76% were practicing surgeons and 13% residents; 33% had performed >200 laparoscopic cases and 13% none. At follow-up, 57% reported very advanced experience; 97% affirmed enhancements in technique and outcomes; 90% noted increased confidence and deemed simulation essential. Procedure-specific relevance was rated 63% for exploratory laparoscopy, 66% for bypass, and 70% for sleeve gastrectomy. Conclusions: Feedback from trainees highlights a simulation course's role in enhancing surgical skills, confidence, and exposure to complex cases. While it is recognized that attaining surgical competency is influenced by multiple factors, this study contributes valuable trainee-centered evidence supporting the positive impact that structured simulation-based training can have in a surgical career.