The impact of Loop Electrosurgical Excision Procedure and cold-knife conization training model on the surgical skills and confidence level

İlker Selçuk; Burak Ersak; Mutlu Umaroğlu; Şule Özel; Hakan Yalçın; Yusuf Üstün; Yaprak Engin-Üstün

doi:10.4274/tjod.galenos.2020.25675

The impact of Loop Electrosurgical Excision Procedure and cold-knife conization training model on the surgical skills and confidence level

Turk J Obstet Gynecol. 2020 Jun;17(2):133-138. doi: 10.4274/tjod.galenos.2020.25675. Epub 2020 Jul 29.

Authors

İlker Selçuk¹, Burak Ersak², Mutlu Umaroğlu³, Şule Özel², Hakan Yalçın¹, Yusuf Üstün⁴, Yaprak Engin-Üstün²

Affiliations

¹ University of Health Sciences Turkey, Zekai Tahir Burak Woman's Health Training and Research Hospital, Clinic of Gynecologic Oncology, Ankara, Turkey.
² University of Health Sciences Turkey, Zekai Tahir Burak Woman's Health Training and Research Hospital, Clinic of Gynecology, Ankara, Turkey.
³ Hacettepe University Faculty of Medicine, Department of Bio-Statistics, Ankara, Turkey.
⁴ University of Health Sciences Turkey, Ankara Training and Research Hospital, Clinic of Gynecology, Ankara, Turkey.

Abstract

Objective: The purpose of this study is to evaluate the impact of loop electrosurgical excision procedure (LEEP) and cold-knife conization (CKC) active training model on the surgical education and confidence levels of gynecologists.

Materials and methods: The LEEP and CKC hands-on training model consists of sausage, which is 2.5 cm in diameter, as cervix; plastic cup as vagina; foam rubber as posterior and anterior fornices; and cotton plate as the leukoplakia area. In total, 34 participants performed LEEP and CKC procedures on the training model under the guidance of mentors after theoretical lessons about the transformation zone, indications, and surgical techniques of LEEP and CKC. Afterward, a web-based survey was conducted to measure the effectiveness of this surgical model, and participants graded their learning and confidence levels on the same.

Results: We evaluated the educational levels of the course, which were based on the basic surgical steps of LEEP and CKC procedures, and the confidence levels of the participants with regard to the previous practice or expertise of LEEP and CKC. Importantly, participants in each group had similar learning gains irrespective of previous practice or expertise. Despite a significantly higher pre-course confidence level of participants who had previously performed LEEP (p<0.001) and CKC (p<0.001) against their non-practitioner counterparts, the post-course confidence levels were similar in each group (p=0.127 and p=0.845, respectively). In both groups, the participants had increased mean confidence scores, which were statistically significant for participants who had not previously performed the procedures (p=0.003, LEEP and p=0.002, CKC, respectively).

Conclusion: This surgical training model on LEEP and CKC can impart a better level of education in participants, irrespective of their previous expertise/practice.

Keywords: LEEP; cervix; conization; education; surgery.