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

Zaibun N Khan; Donna Shrestha; Abdulwarith Shugaba; Joel E Lambert; Justin Clark; Elizabeth Haslett; Karolina Afors; Theodoros M Bampouras; Christopher J Gaffney; Daren A Subar

doi:10.1136/bmjopen-2023-075113

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

Zaibun N Khan, Donna Shrestha, Abdulwarith Shugaba, Joel E Lambert, Justin Clark, Elizabeth Haslett, Karolina Afors, Theodoros M Bampouras, Christopher J Gaffney^*, Daren A Subar

^*Corresponding author for this work

Metabolism and Systems Science

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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).

Original language	English
Article number	e075113
Number of pages	9
Journal	BMJ open
Volume	13
Issue number	11
DOIs	https://doi.org/10.1136/bmjopen-2023-075113
Publication status	Published - 10 Nov 2023

Bibliographical note

Funding:
This study was funded by grants from the British Society of Gynaecological Endoscopy, Karl Storz and Medtronic.

Keywords

medical education & training
obstetrics
gynaecology

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Khan, Z. N., Shrestha, D., Shugaba, A., Lambert, J. E., Clark, J., Haslett, E., Afors, K., Bampouras, T. M., Gaffney, C. J., & Subar, D. A. (2023). 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, 13(11), Article e075113. https://doi.org/10.1136/bmjopen-2023-075113

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title = "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",

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 = "medical education & training, obstetrics, gynaecology",

author = "Khan, {Zaibun N} and Donna Shrestha and Abdulwarith Shugaba and Lambert, {Joel E} and Justin Clark and Elizabeth Haslett and Karolina Afors and Bampouras, {Theodoros M} and Gaffney, {Christopher J} and Subar, {Daren A}",

note = "Funding: This study was funded by grants from the British Society of Gynaecological Endoscopy, Karl Storz and Medtronic.",

year = "2023",

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doi = "10.1136/bmjopen-2023-075113",

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Khan, ZN, Shrestha, D, Shugaba, A, Lambert, JE, Clark, J, Haslett, E, Afors, K, Bampouras, TM, Gaffney, CJ & Subar, DA 2023, '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, vol. 13, no. 11, e075113. https://doi.org/10.1136/bmjopen-2023-075113

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. / Khan, Zaibun N; Shrestha, Donna; Shugaba, Abdulwarith et al.
In: BMJ open, Vol. 13, No. 11, e075113, 10.11.2023.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Comparing proficiency of obstetrics and gynaecology trainees with general surgery trainees using simulated laparoscopic tasks in Health Education England, North-West

T2 - a prospective observational study

AU - Khan, Zaibun N

AU - Shrestha, Donna

AU - Shugaba, Abdulwarith

AU - Lambert, Joel E

AU - Clark, Justin

AU - Haslett, Elizabeth

AU - Afors, Karolina

AU - Bampouras, Theodoros M

AU - Gaffney, Christopher J

AU - Subar, Daren A

N1 - Funding: This study was funded by grants from the British Society of Gynaecological Endoscopy, Karl Storz and Medtronic.

PY - 2023/11/10

Y1 - 2023/11/10

N2 - 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).

AB - 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).

KW - medical education & training

KW - obstetrics

KW - gynaecology

U2 - 10.1136/bmjopen-2023-075113

DO - 10.1136/bmjopen-2023-075113

M3 - Article

SN - 2044-6055

VL - 13

JO - BMJ open

JF - BMJ open

IS - 11

M1 - e075113

ER -

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

Abstract

Bibliographical note

Keywords

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