Background

Implementation of the Fundamentals of Laparoscopic Surgery (FLS) by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has served a need for educational structure for laparoscopic skill within General Surgery training since 2004. This study looks at how FLS affects resident self-efficacy (SE) with laparoscopic procedures.

Methods

We conducted a national survey, linked to the 2020 American Board of Surgery In-Training Examination (ABSITE), in which 9275 residents from 325 US General Surgery Training Programs participated. The online survey included multimodal questions that analyzed whether participants felt they could perform the most commonly-logged laparoscopic operations among residents [Laparoscopic Appendectomy (LA), Laparoscopic Cholecystectomy (LC), Laparoscopic Right Hemicolectomy (LRH), Diagnostic Laparoscopy (DL)] without faculty assistance. This used a 5-point scaled assessment, ranging from “not able to” to “definitely able to.” Multivariate analyses determined if completion of FLS made a difference for resident self-efficacy, stratified by post-graduate year (PGY).

Results

At the time of the survey, 2300 reported completion of FLS. The percentage of FLS completion increased from PGY1 to PGY5 (4.2% n = 59 vs 85.8% n = 893). PGY1 residents who completed FLS, from 48 diverse institutions, demonstrated the most significant increases in SE (p < 0.05) with significantly higher perceived self-efficacy in LA (p = 0.001) and LRH (p = 0.012). PGY2 and PGY3 residents indicated increased SE in DL (p = 0.037, p = 0.015, respectively), based on FLS completion. These FLS effects were less evident in the more senior classes.

Conclusions

Completion of FLS arguably has the greatest benefits for more junior residents, as it establishes a foundation of laparoscopic knowledge and skill, upon which further residency training can build. Successful completion of the curriculum and assessment offered by the Fundamentals of Laparoscopic Surgery leads to greater sense of ability in early trainees.

中文翻译：

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普通外科住院医师中腹腔镜手术的基础：初级住院医师自我效能感的基础

背景

自 2004 年以来，美国胃肠和内窥镜外科医生协会 (SAGES) 实施的《腹腔镜手术基础》(FLS) 满足了普通外科培训中腹腔镜技能教育结构的需要。本研究着眼于 FLS 如何影响住院医生的自我效能感(SE) 腹腔镜手术。

方法

我们进行了一项与 2020 年美国外科委员会培训考试 (ABSITE) 相关的全国调查，来自 325 个美国普通外科培训项目的 9275 名住院医生参加了调查。在线调查包括多模式问题，分析参与者是否认为他们可以执行居民中最常记录的腹腔镜手术[腹腔镜阑尾切除术（LA）、腹腔镜胆囊切除术（LC）、腹腔镜右半结肠切除术（LRH）、诊断性腹腔镜检查（DL）]师资协助。该评估采用 5 分制评估，范围从“不能”到“绝对能够”。多变量分析确定 FLS 的完成是否对住院医师自我效能感产生影响，并按研究生年份 (PGY) 分层。

结果

在调查时，有 2300 人报告完成了 FLS。FLS 完成百分比从 PGY1 增加到 PGY5（4.2% n  = 59 vs 85.8% n  = 893）。来自 48 个不同机构的完成 FLS 的 PGY1 居民表现出 SE (p < 0.05)最显着的增加，并且 LA ( p  = 0.001) 和 LRH ( p  = 0.012) 的 自我效能感明显更高。 根据 FLS 完成情况，PGY2 和 PGY3 居民表示 DL 的 SE 增加（分别为p  = 0.037、p = 0.015）。这些 FLS 效应在高年级班级中不太明显。

结论

完成 FLS 可以说对更多初级住院医师来说是最大的好处，因为它奠定了腹腔镜知识和技能的基础，在此基础上可以进行进一步的住院医师培训。成功完成《腹腔镜手术基础》提供的课程和评估可以提高早期学员的能力感。