Identifying the needs for teaching fundamental knowledge of laparoscopic surgery: a cross-sectional study in Japan
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Recently, laparoscopic surgery (LS) has become a more common procedure than traditional open surgery. Although LS-related adverse events have been reported, there is no formal, standardized curriculum to teach the fundamentals of LS in Japan. Understanding surgeons’ knowledge regarding LS is crucial for developing an educational curriculum. The purpose of this study was to determine the baseline knowledge on LS of surgeons and surgical trainees in Japan.
Participants completed 24 multiple-choice questions testing basic cognitive knowledge of LS and a questionnaire regarding the status of laparoscopic education. The examination was developed according to the 13 content domains of the Fundamentals of Laparoscopic Surgery (FLS) program. Scores were compared between post-graduate year (PGY) > 5 and PGY 1–5 participants. Data are expressed as median scores and interquartile ranges. Wilcoxon signed-rank test was used for statistical analysis.
A total of 195 surgeons and surgical trainees from 10 teaching hospitals (PGY1–5: 66, PGY > 5: 129) across Japan completed the examination. The median score in the entire cohort was 75 [67; 83] %, with significantly higher scores in the PGY > 5 group compared to the PGY1–5 group (79 [75; 83] % vs. 67 [58; 75] %, p < 0.001). The differences in performance were due to better scores for PGY > 5 group on the sections “equipment,” “patient considerations,” “abdominal access,” “tissue handling,” “hemorrhage and hemostasis,” “tissue approximation,” and “exiting the abdomen.” Overall, the median scores in the “energy sources” and “establishment and physiology of the pneumoperitoneum” subsections were lower than in other domains. All participants agreed on the need for fundamental knowledge and a formal educational curriculum.
Compared to experienced surgeons, surgical trainees had lesser knowledge about performing LS. Regardless of the years of experience, there are crucial knowledge gaps in specific areas regarding safe LS that should be addressed by implementing an educational curriculum.
KeywordsPatient safety Competence Surgical education Continuing medical education Evaluation Laparoscopic surgery
The authors would like to thank Manabu Yamamoto, Tomoko Mizota, JASE members, and local residency program directors of teaching hospitals, surgeons, and trainees for their participation in this study. We could not have completed the survey study without their support.
Compliance with ethical standards
Drs. Shinichiro Yokoyama, Yusuke Watanabe, Yo Kurashima, Akihiko Oshita, Yuji Nishizawa, Takeshi Naitoh, Fumitaka Nakamura, Satoru Kikuchi, Kazuhiro Noma, Saseem Poudel, Akihiro Suzuki, Yuichi Nishihara, Masaaki Ito, and Satoshi Hirano have no conflicts of interest or financial ties to disclose associated with this manuscript.
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