Stepwise training program: A novel practice schedule for laparoscopic suturing
Hsin-An Chen,
Shih-Wei Huang,
Shih-Chiang Shen,
Kuei‐Yen Tsai,
Hsin-Hong Kuo,
Bernard Dallemagne,
Howard C. Jen,
Chin-Hung Wei
Affiliations
Hsin-An Chen
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Shih-Wei Huang
IRCAD/AITS-Asian Institute of TeleSurgery, Show Chwan Health Care System, Changhua, Taiwan; Division of General Surgery, Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan; Division of General Surgery, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
Shih-Chiang Shen
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
Kuei‐Yen Tsai
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Hsin-Hong Kuo
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan
Bernard Dallemagne
Department of Digestive and Endocrine Surgery, University Hospital, Strasbourg, France; IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
Howard C. Jen
Division of Pediatric Surgery, Mattel Children's Hospital at University of California Los Angeles, Los Angeles, USA
Chin-Hung Wei
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pediatric Surgery, Department of Surgery, Shuang Ho Hospital, New Taipei City, Taiwan; Corresponding author. Address: No.291, Zhongzheng Rd., Zhonghe Dist., New Taipei City 235, Taiwan.
Purpose: We establish stepwise training program in which laparoscopic suturing is broken down to discrete steps. The purpose is to evaluate the learning outcomes of stepwise training program. Materials and methods: Volunteer participants were enrolled from medical students and surgical trainees. Students took two courses of 2-h stepwise training, and a post-course (1st & 2nd) test was taken after each course; trainees took one course of stepwise training with a pre-course (1st) and a post-course (2nd) test. Attending surgeons took the test as control. Learning outcomes were assessed with laparoscopic suturing competency assessment tool (LS-CAT) and suturing time. Results: There were 10 students, 8 trainees and 6 surgeon controls. Suturing time and LS-CAT scores significantly improved between the 1st and 2nd test (p < 0.01). In the both tests, suturing time and LS-CAT scores of students and trainees were similar. In the 1st test, surgeons had significantly better performance in suturing time and LS-CAT score than students and trainees; in the 2nd test, the LS-CAT scores of students and trainees were similar to the surgeon controls. Conclusions: Stepwise program effectively enhances laparoscopic suturing skill for medical students and surgical trainees. Catch-up effect was demonstrated in medical students with stepwise training.
