TY - JOUR

T1 - Module based training improves and sustains surgical skills

T2 - a randomised controlled trial

AU - Carlsen, C G

AU - Lindorff-Larsen, K

AU - Funch-Jensen, P

AU - Lund, L

AU - Konge, L

AU - Charles, P

PY - 2015/10

Y1 - 2015/10

N2 - PURPOSE: Traditional surgical training is challenged by factors such as patient safety issues, economic considerations and lack of exposure to surgical procedures due to short working hours. A module-based clinical training model promotes rapidly acquired and persistent surgical skills.METHODS: A randomised controlled trial concerning supervised hernia repair in eight training hospitals in Denmark was performed. The participants were 18 registrars [Post graduate year (PGY) 3 or more] in their first year of surgical specialist training. The intervention consisted of different modules with a skills-lab course followed by 20 supervised Lichtenstein hernia repairs. Operative performance was video recorded and blindly rated by two consultants using a previously validated skills rating scale (8-40 points). Outcome measures were change in the ratings of operative skills and operative time.RESULTS: In the intervention group (n = 10) the average rating of operative skills before intervention was 22.5 (20.6-24.3) and after 26.2 (23.5-28.8), p = 0.044. At follow-up after 1 year, rating was 26.9 (23.4-30.4), p = 0.019. In the conventionally trained group average rating was 23.4 (19.4-27.3) at start and 21.7 (17.3-26.1) at end, p = 0.51. At start no difference was detected between the two groups, p = 0.59; by 1 year the difference was statistically significant favouring intervention, p = 0.044. Operative time showed similar results in favour of the intervention.CONCLUSIONS: A module-based training model in Lichtenstein hernia repair was preferable in both short and long-term compared with standard clinical training. The model will probably be applicable to other surgical training procedures.

AB - PURPOSE: Traditional surgical training is challenged by factors such as patient safety issues, economic considerations and lack of exposure to surgical procedures due to short working hours. A module-based clinical training model promotes rapidly acquired and persistent surgical skills.METHODS: A randomised controlled trial concerning supervised hernia repair in eight training hospitals in Denmark was performed. The participants were 18 registrars [Post graduate year (PGY) 3 or more] in their first year of surgical specialist training. The intervention consisted of different modules with a skills-lab course followed by 20 supervised Lichtenstein hernia repairs. Operative performance was video recorded and blindly rated by two consultants using a previously validated skills rating scale (8-40 points). Outcome measures were change in the ratings of operative skills and operative time.RESULTS: In the intervention group (n = 10) the average rating of operative skills before intervention was 22.5 (20.6-24.3) and after 26.2 (23.5-28.8), p = 0.044. At follow-up after 1 year, rating was 26.9 (23.4-30.4), p = 0.019. In the conventionally trained group average rating was 23.4 (19.4-27.3) at start and 21.7 (17.3-26.1) at end, p = 0.51. At start no difference was detected between the two groups, p = 0.59; by 1 year the difference was statistically significant favouring intervention, p = 0.044. Operative time showed similar results in favour of the intervention.CONCLUSIONS: A module-based training model in Lichtenstein hernia repair was preferable in both short and long-term compared with standard clinical training. The model will probably be applicable to other surgical training procedures.

U2 - 10.1007/s10029-015-1357-6

DO - 10.1007/s10029-015-1357-6

M3 - Journal article

C2 - 25731946

VL - 19

SP - 755

EP - 763

JO - Hernia : the journal of hernias and abdominal wall surgery

JF - Hernia : the journal of hernias and abdominal wall surgery

SN - 1265-4906

IS - 5

ER -