A feasibility and preliminary effectiveness study of a tiered gynecological laparoscopic training curriculum in southwestern China

Essential yet deficient gynecological laparoscopy training in China demands urgent structured solutions. This study aimed to develop and preliminarily evaluate a specialized laparoscopic surgical training curriculum for enhancing surgical skills among gynecologists.

Our laparoscopic training program ran from September 2022 to December 2025 and comprised three phases. Phase I developed a laparoscopic skills curriculum through needs assessment, hierarchical task analysis, and expert panel consensus. Phase II surveyed 112 participants (junior, intermediate, and senior groups) using Likert-scale and ranking questions to evaluate satisfaction and perceived effectiveness. Phase III conducted pre-/post-training assessments of pattern cutting and suturing tasks in 37 participants, analyzing relationships to external variables. We employed the Shapiro-Wilk test, Kruskal-Wallis test, Wilcoxon signed-rank test, and paired samples t-test for statistical analyses (significance: P < 0.05).

A total of 112 trainees were enrolled and divided into junior (n = 34), intermediate (n = 47), and senior (n = 31) groups. Overall training satisfaction was high and comparable among groups across most dimensions, except that prior laparoscopic training experience was associated with greater satisfaction regarding training productivity. Trainees showed significant post-training improvements in self-assessed laparoscopic skills, including hand-eye coordination, bimanual dexterity, energy device use, and suturing (all P < 0.001). Perfused organ modules were the most preferred training component overall, with notable level-stratified differences: seniors favored perfused and ex vivo organs, intermediates preferred perfused organs and box-trainers, whereas juniors prioritized box-trainers and theoretical instruction. Post-training objective assessments (n = 37) revealed significantly reduced operation time in pattern cutting and suturing tasks, as well as improved suturing quality (all P < 0.05). Multivariate regression showed that improvements in suturing skills were not significantly associated with age, seniority, or previous training history.

Training preferences differed by proficiency level: juniors preferred theory and simulators, whereas intermediate and senior trainees favored perfused and ex vivo practice. This stratified model is feasible and effective for standardized laparoscopic training.