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

doi:10.1016/j.heliyon.2023.e22563

Stepwise training program: A novel practice schedule for laparoscopic suturing

Heliyon. 2023 Nov 28;9(12):e22563. doi: 10.1016/j.heliyon.2023.e22563. eCollection 2023 Dec.

Authors

Hsin-An Chen^{1

2

3}, Shih-Wei Huang^{4

5

6}, Shih-Chiang Shen^{1

2}, Kuei-Yen Tsai^{1

2

3}, Hsin-Hong Kuo⁷, Bernard Dallemagne^{8

9}, Howard C Jen¹⁰, Chin-Hung Wei^{1

11}

Affiliations

¹ Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
² Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
³ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ IRCAD/AITS-Asian Institute of TeleSurgery, Show Chwan Health Care System, Changhua, Taiwan.
⁵ Division of General Surgery, Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan.
⁶ Division of General Surgery, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
⁷ Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan.
⁸ Department of Digestive and Endocrine Surgery, University Hospital, Strasbourg, France.
⁹ IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France.
¹⁰ Division of Pediatric Surgery, Mattel Children's Hospital at University of California Los Angeles, Los Angeles, USA.
¹¹ Division of Pediatric Surgery, Department of Surgery, Shuang Ho Hospital, New Taipei City, Taiwan.

Abstract

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.

Keywords: Laparoscopic suturing; Practice schedule; Stepwise training.