Formal teaching of surgical skills in an obstetric-gynecologic residency*1

Abstract

OBJECTIVE: To describe a formal teaching program of basic surgical skills in an obstetric-gynecologic residency program and evaluate its effectiveness. METHODS: A surgical skills program was developed for all residents. Using bench and animal laboratory sessions, residents were given instruction and performed both laparoscopic and open abdominal procedures. All were given a pretest and were tested again 6 months later. Residents also evaluated their experiences. RESULTS: To date, the formal teaching sessions have been given to 24 residents, all of whom believed their confidence and technical skills improved as a result of the sessions. On a scale of 1 to 5, the median rating of the bench laboratory experience was 5 (range 4-5), and the pig laboratory was 5 (range 4-5). All residents believed the surgery sessions should be continued and the number of sessions increased. Preliminary evaluation indicated that time to suture a 10-inch incision decreased by 28%, from an average of 225 (standard deviation [SD] 51) seconds to 171 (SD 43) seconds (P < .001), and evaluation of surgical technique significantly improved at the second pretest (P = .013). Laparoscopic placement of pegs on a board in 2 minutes increased from an average of 5 (SD 2.5) to 7.3 (SD 2.6; P = .001). The cost of the bench laboratory sessions was minimal. Each pig was approximately $100, and the facility charge for each 4-hour laboratory session was $1500. CONCLUSION: When formal surgical training was given to obstetric-gynecologic residents, their surgical skills improved subjectively and objectively.