Comparing proficiency of obstetrics and gynaecology trainees with general surgery trainees using simulated laparoscopic tasks in Health Education England, North-West: a prospective observational study

BMJ Open. 2023 Nov 10;13(11):e075113. doi: 10.1136/bmjopen-2023-075113.

Abstract

Background: Training programmes for obstetrics and gynaecology (O&G) and general surgery (GS) vary significantly, but both require proficiency in laparoscopic skills. We sought to determine performance in each specialty.

Design: Prospective, observational study.

Setting: Health Education England North-West, UK.

Participants: 47 surgical trainees (24 O&G and 23 GS) were subdivided into four groups: 11 junior O&G, 13 senior O&G, 11 junior GS and 12 senior GS trainees.

Objectives: Trainees were tested on four simulated laparoscopic tasks: laparoscopic camera navigation (LCN), hand-eye coordination (HEC), bimanual coordination (BMC) and suturing with intracorporeal knot tying (suturing).

Results: O&G trainees completed LCN (p<0.001), HEC (p<0.001) and BMC (p<0.001) significantly slower than GS trainees. Furthermore, O&G found fewer number of targets in LCN (p=0.001) and dropped a greater number of pins than the GS trainees in BMC (p=0.04). In all three tasks, there were significant differences between O&G and GS trainees but no difference between the junior and senior groups within each specialty. Performance in suturing also varied by specialty; senior O&G trainees scored significantly lower than senior GS trainees (O&G 11.4±4.4 vs GS 16.8±2.1, p=0.03). Whilst suturing scores improved with seniority among O&G trainees, there was no difference between the junior and senior GS trainees (senior O&G 11.4±4.4 vs junior O&G 3.6±2.1, p=0.004).

Discussion: GS trainees performed better than O&G trainees in core laparoscopic skills, and the structure of O&G training may require modification.

Trial registration number: ClinicalTrials.gov Registry (NCT05116332).

Keywords: gynaecology; medical education & training; obstetrics.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Competence
  • England
  • General Surgery* / education
  • Gynecology* / education
  • Health Education
  • Humans
  • Laparoscopy* / education
  • Prospective Studies
  • Suture Techniques

Associated data

  • ClinicalTrials.gov/NCT05116332