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. 2022 Jul;36(7):5483-5490.
doi: 10.1007/s00464-021-08880-6. Epub 2022 Jan 8.

Development of a simulation curriculum to teach and assess advanced laparoscopic suturing skills using telesimulation: a feasibility study

Elif Bilgic  1   2   3 , Allan Okrainec  4   5   6 , Sofia Valanci  2 , Adam Di Palma  5 , Andras Fecso  5 , Pepa Kaneva  2 , Caterina Masino  6 , Yusuke Watanabe  7 , Melina C Vassiliou  2   3 , Liane S Feldman  2   3 , Gerald M Fried  8   9   10
Affiliations

Development of a simulation curriculum to teach and assess advanced laparoscopic suturing skills using telesimulation: a feasibility study

Elif Bilgic et al. Surg Endosc. 2022 Jul.

Abstract

Background: Telesimulation helps overcome limitations in time and local expertise by eliminating the need for the learner and educator to be physically co-located, especially important during COVID-19. We investigated whether teaching advanced laparoscopic suturing (ALS) through telesimulation is feasible, effective, and leads to improved suturing in the operating room (OR).

Methods: In this prospective feasibility study, three previously developed 3D-printed ALS tasks were used: needle handling (NH), suturing under tension (UT), and continuous suturing (CS). General surgery residents (PGY4-5) underwent 1-month of telesimulation training, during which an expert educator at one site remotely trained residents at the other site over 2-3 teaching sessions. Trainees were assessed in the three tasks and in the OR at three time points: baseline(A1), control period(A2), and post-intervention(A3) and completed questionnaires regarding educational value and usability of telesimulation. Paired t-test was used to compare scores between the three assessment points.

Results: Six residents were included. Scores for UT improved significantly post-intervention A3(568 ± 60) when compared to baseline A1(416 ± 133) (p < 0.019). Similarly, scores for CS improved significantly post-intervention A3(756 ± 113) vs. baseline A1(539 ± 211) (p < 0.02). For intraoperative assessments, scores improved significantly post-intervention A3(21 ± 3) when compared to both A1(17 ± 4) (p < 0.018) and A2(18 ± 4) (p < 0.0008). All residents agreed that tasks were relevant to practice, helped improve technical competence, and adequately measured suturing skill. All residents found telesimulation easy to use, had strong educational value, and want the system to be incorporated into their training.

Conclusion: The use of telesimulation for remotely training residents using ALS tasks was feasible and effective. Residents found value in training using the tasks and telesimulation system, and improved ALS skills in the OR. As the pandemic has caused a major structural shift in resident education, telesimulation can be an effective alternative to on-site simulation programs. Future research should focus on how telesimulation can be effectively incorporated into training programs.

Keywords: Advanced laparoscopic suturing; Laparoscopy; Simulation; Surgical education; Telesimulation.

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Conflict of interest statement

Dr. Fried is a consultant to Theator. Dr. Okrainec reports honoraria fees for speaking and teaching from Medtronic, Ethicon, and Merck. Pepa Kaneva, Caterina Masino, and Drs Elif Bilgic, Allan Okrainec, Sofia Valanci, Adam DiPalma, Andras Fecso, Yusuke Watanabe, Melina C Vassiliou, Liane S Feldman, and Gerald M Fried report no relevant conflicts of interest or financial ties to disclose related to the content of this research.

Figures

Fig. 1
Fig. 1
Study design
See this image and copyright information in PMC

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