Development of a Comprehensive Ex-vivo Technical Skills Curriculum for an Advanced Minimally Invasive Surgical Procedure

It is well recognized that a certain component of surgical residency training has transitioned from the operating room to the surgical skills lab. Although a significant amount of important work has validated simulators as viable systems for teaching technical skills outside the operating room, the next step is integrating simulators into a comprehensive curriculum. Several frameworks for curricular design have been described in the literature; however, few curricula have been described or validated for minimally invasive surgical procedures. This study describes the design and validation of a comprehensive technical skills curriculum for laparoscopic colorectal surgery, an advanced laparoscopic procedure. The initial step in this project utilized the Delphi consensus methodology to develop a procedure-specific evaluation tool for laparoscopic colorectal surgery. This evaluation tool demonstrated reliability and validity in the context of expert and novice performance in the operating room. The next phase of the project also used the Delphi method to develop international consensus on a proficiency-based virtual reality program designed to teach the technical skills necessary to perform laparoscopic colorectal surgery. This virtual reality training program was then integrated into a comprehensive curriculum consisting of psychomotor training on the virtual reality simulator, as well as cognitive training and a cadaver lab. The final component of this project was a randomized single-blinded controlled trial that demonstrated that surgical residents who participated in the comprehensive curriculum exhibited superior technical skills in the operating room, and superior cognitive knowledge relating to laparoscopic colorectal surgery, compared to residents who received only conventional residency training.Ph