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Evaluation of laparoscopic skills: a 2-year follow-up during residency training.

OBJECTIVE
To evaluate laparoscopic technical skill in surgical residents over a 2-year period.


DESIGN
The laparoscopic technical skills of general surgical residents were evaluated using the MISTELS program. This provides an objective evaluation of laparoscopic skill, taking into account precision and speed.


SETTING
Inanimate laparoscopic skills centre.


PARTICIPANTS
Ten general surgical residents (5 PGY1, 3 PGY2 and 2 PGY3 residents) who were required to complete 3 structured laparoscopic tasks.


OUTCOME MEASURES
A composite score incorporating precision and timing was assigned to each task. The paired t-test was used to compare performance of each resident at the 2 levels of their residency training for each task. Linear regression analysis was used to correlated level of training and total score (sum of all tasks).


RESULTS
Linear regression analysis demonstrated a highly significant correlation between level of training and total score (r = 0.82, p < 0.01). There was a significant increase in scores in the cutting and suturing task over the 2-year period (p < 0.01). Transferring skills did not improve significantly (p = 0.11).


CONCLUSIONS
Performance in the simulator improved over residency training and was correlated highly with postgraduate year. This simulator model is a valuable teaching tool for training and evaluation of basic laparoscopic tasks in laparoscopic surgery.