What are the Training Gaps for Acquiring Laparoscopic Suturing Skills?

• Published in: Journal of surgical education 2017-07, Vol.74 (4), p.656-662
• Main Authors: Enani, Ghada, MBBS, MEd, Watanabe, Yusuke, MD, PhD, McKendy, Katherine M., MD, MEd, Bilgic, Elif, BSc, Feldman, Liane S., MD, Fried, Gerald M., MD, Vassiliou, Melina C., MD, MEd
• Format: Article
• Language: English
• Subjects: Adult; advanced laparoscopy; Clinical Competence; Education, Medical, Graduate; Female; General Surgery - education; Humans; Internship and Residency; Interviews as Topic; laparoscopic suturing; Laparoscopy - education; Learning Curve; Male; Medical Knowledge; Practice-Based Learning and Improvement; Qualitative Research; resident; Surgery; surgical education; surgical simulation; Suture Techniques - education
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2016.12.004

Introduction Advanced laparoscopic suturing is considered a challenging skill to acquire. The aim of this study was to investigate the learning process for advanced laparoscopic suturing in the operating room to understand the obstacles trainees face when trying to master the skill. Methods A qualitative methodology using semistructured interviews and field observations was used. Data were analyzed using a Grounded Theory approach. Participants were general surgery residents and surgeons with advanced minimally invasive surgery (MIS) experience. Results Ten MIS surgeons across different institutions and 15 local general surgery residents were interviewed. The semistructured interviews and field observations of 9 advanced MIS operations (27 h) yielded the following 6 themes around the acquisition of laparoscopic suturing skills for residents: complexity, training misalignment, variability of opportunities, inconsistency of techniques, lack of feedback, and differing expectations. Conclusion There are several unmet training needs around laparoscopic suturing skills. Training for advanced laparoscopic skills requires more emphasis on coaching and the development of advanced models. This study heralded the need to incorporate advanced laparoscopic skills into the surgical simulation curriculum.