A Competency-based Laparoscopic Cholecystectomy Curriculum Significantly Improves General Surgery Residents' Operative Performance and Decreases Skill Variability Cohort Study

Elizabeth M Huffman; Jennifer N Choi; John R Martin; Nicholas E Anton; Brianne L Nickel; Sara Monfared; Lava R Timsina; Gary L Dunnington; Dimitrios Stefanidis

doi:10.1097/SLA.0000000000004853

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A Competency-based Laparoscopic Cholecystectomy Curriculum Significantly Improves General Surgery Residents' Operative Performance and Decreases Skill Variability Cohort Study

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A Competency-based Laparoscopic Cholecystectomy Curriculum Significantly Improves General Surgery Residents' Operative Performance and Decreases Skill Variability Cohort Study

Elizabeth M Huffman, Jennifer N Choi, John R Martin, Nicholas E Anton, Brianne L Nickel, Sara Monfared, Lava R Timsina, Gary L Dunnington and Dimitrios Stefanidis

Annals of surgery, Vol.276(6), pp.E1083-E1088

12/01/2022

DOI: 10.1097/SLA.0000000000004853

PMID: 33914474

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Abstract

Objective:To demonstrate the feasibility of implementing a CBE curriculum within a general surgery residency program and to evaluate its effectiveness in improving resident skill. Summary of Background Data:Operative skill variability affects residents and practicing surgeons and directly impacts patient outcomes. CBE can decrease this variability by ensuring uniform skill acquisition. We implemented a CBE LC curriculum to improve resident performance and decrease skill variability. Methods:PGY-2 residents completed the curriculum during monthly rotations starting in July 2017. Once simulator proficiency was reached, residents performed elective LCs with a select group of faculty at 3 hospitals. Performance at curriculum completion was assessed using LC simulation metrics and intraoperative operative performance rating system scores and compared to both baseline and historical controls, comprised of rising PGY-3s, using a 2-sample Wilcoxon rank-sum test. PGY-2 group's performance variability was compared with PGY-3s using Levene robust test of equality of variances; P < 0.05 was considered significant. Results:Twenty-one residents each performed 17.52 +/- 4.15 consecutive LCs during the monthly rotation. Resident simulated and operative performance increased significantly with dedicated training and reached that of more experienced rising PGY-3s (n = 7) but with significantly decreased variability in performance (P = 0.04). Conclusions:Completion of a CBE rotation led to significant improvements in PGY-2 residents' LC performance that reached that of PGY-3s and decreased performance variability. These results support wider implementation of CBE in resident training.

Surgery

Life Sciences & Biomedicine

Science & Technology

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Title: Subtitle: A Competency-based Laparoscopic Cholecystectomy Curriculum Significantly Improves General Surgery Residents' Operative Performance and Decreases Skill Variability Cohort Study
Creators: Elizabeth M Huffman - Indiana University School of Medicine
Jennifer N Choi - University of Indianapolis
John R Martin - Indiana University School of Medicine
Nicholas E Anton - Indiana University School of Medicine
Brianne L Nickel - Indiana University School of Medicine
Sara Monfared - Indiana University School of Medicine
Lava R Timsina - Indiana University School of Medicine
Gary L Dunnington - Indiana University School of Medicine
Dimitrios Stefanidis - Indiana University School of Medicine
Resource Type: Journal article
Publication Details: Annals of surgery, Vol.276(6), pp.E1083-E1088
DOI: 10.1097/SLA.0000000000004853
PMID: 33914474
ISSN: 0003-4932
eISSN: 1528-1140
Publisher: Lippincott Williams & Wilkins
Number of pages: 6
Language: English
Date published: 12/01/2022
Academic Unit: Surgery
Record Identifier: 9985138660402771

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