Preparing Residents for Surgery Using a Low-cost Laparoscopic Salpingectomy Simulation

Introduction: Laparoscopic salpingectomy is a commonly performed procedure and is often one of the first laparoscopic procedures performed by novice residents in Obstetrics and Gynecology (OB/GYN). Opportunities to practice before the operating room can be limited. Methods: We developed an animal tissue model and incorporated it into a laparoscopic salpingectomy simulation for OB/GYN residents in a single academic program. The simulation included a pre-simulation video describing the steps of laparoscopic salpingectomy, the laparoscopic salpingectomy simulation using an electrosurgical device, a post simulation survey, and debriefing with learner targeted feedback. Validity evidence for the simulation model was gathered using the Messick framework. Resident performance was assessed using the Objective Structured Assessment of Laparoscopic Salpingectomy (OSA-LS) and the Global Operative Assessment of Laparoscopic Skills (GOALS). Performance was correlated to the year of training with upper-level residents grouped for analysis. Results: Twenty-five simulations of laparoscopic salpingectomy were performed by 14 learners (first through fourth year). The tool was highly rated by participants. We found a significant correlation between the mean OSA-LS score and surgical experience. The mean GOALS score also increased with experience and was significantly different between 1st and 2nd years and between 1st and upper-level residents. A passing score of 12 was established for each assessment rubric. Discussion: This low-cost surgical model addresses a gap in simulation options for preoperative use of electrosurgical devices. This simulation can be used in OB GYN residency as a method to assess competency or provide feedback.