Impact of Simulation-Based Surgical Training in Laparoscopy on Satisfaction Level and Proficiency in Surgical Skills.

Abstract

Introduction: The adoption of laparoscopic surgery has significantly transformed surgical practice. However, mastering these techniques requires specialized training. In Saudi Arabia, the level of proficiency in laparoscopic skills among General Surgery (GS) trainees is not well-documented. This study aims to assess GS residents' satisfaction with their laparoscopic training, self-appraise their proficiency, and objectively evaluate their skills using the Fundamentals of Laparoscopic Surgery (FLS) test.

Methods: This cross-sectional study, approved by the Institutional Review Board and funded by Alfaisal University, took place between October 2021 and May 2023. It involved a two-part approach: an online survey and objective FLS testing. The survey, distributed to GS residents in seven government hospitals in Riyadh, captured self-reported satisfaction and subjective proficiency data. Subsequently, residents who volunteered for FLS testing were objectively assessed using standardized criteria.

Results: Of 195 residents, 70 (36%) responded to the survey. Satisfaction with academic teaching and hands-on training in laparoscopic surgery was low (24% and 44%, respectively), while 62% were satisfied with case volume. Self-assessed proficiency was higher for basic skills than for advanced skills like extra-corporeal and intracorporeal knotting. Only a third had been exposed to laparoscopic trainers, and 14.3% had FLS certification prior. Fourteen residents participated in FLS testing, revealing a 36% failure rate in task completion. Prior simulation practice or laparoscopic training certification significantly improved performance (p<0.001), reflected by achieving higher scores and passing FLS proficiency scores.

Conclusion: Despite satisfaction with exposure to laparoscopic surgeries, the study highlights a considerable gap in satisfaction and proficiency among GS residents in Saudi Arabia, particularly in advanced laparoscopic skills. The positive impact of simulation-based practice and laparoscopic training certification underscores the need for structured training programs. Addressing these gaps, through integrating comprehensive simulation-based programs and promoting laparoscopic skill certification, is crucial for enhancing surgical education and training outcomes.