Abstract

Introduction: Laparoscopic appendicectomy is a procedure to which surgical trainees have an early exposure. Structured training may enhance learning. We present a brief overview of the lessons learned from implementing a structured training programme.

Methods: A training programme based on standardization, simulation, structured training, and evaluation was implemented during an 18-month period at Stavanger University Hospital. Evaluation was completed after each session by trainee and trainer. Construct validity was considered by analyzing the variance across experience levels. Agreement between trainees’ self-assessment and trainers’ assessment of technical skills were reported by intraclass correlation coefficient (ICC). Learning curves (by LOWESS curves) were achieved by plotting experience against a validated 6-point scale, with scores ≥5 indicating proficiency. The use of simulation prior to surgery was registered. 

Results: Across 409 procedures, some 173 were completed by junior trainees in a structured training. Construct validity was confirmed. Agreement between trainees’ self-assessment and trainers’ assessment on all technical skills was good (overall ICC of 0.88). The trainees were satisfied overall with the training. Learning curves demonstrated the inflection point for procedure proficiency at about 30 procedures, but with considerable variations between different procedural steps. The use of simulation-training prior to surgery decreased with increasing experience.

Conclusions: A structured training programme demonstrates variation in procedures needed to obtain proficiency and across technical steps. Variations in the learning curves should mandate focused training of mastery of procedure steps.

Additional Information

This presentation was given at the SES 2022 online conference, January 2022.