Sharper Skills: A Needs Assessment for a Laparoscopic Training Curriculum

Introduction: General surgery residents must complete basic and complex laparoscopic procedures and pass the Fundamentals of Laparoscopic Surgery (FLS) exam by graduation for board eligibility.Surgical physician assistant (PA) trainees face no analogous credentialing thresholds, yet are expected to graduate prepared to manage perioperative care and assist with laparoscopic procedures competently.Given these distinct but overlapping training demands, we conducted a needs assessment to identify gaps, if any, in our institution's current educational paradigm for preparing both general surgery residents and surgical PA trainees to meet their respective competency expectations.Materials and methods: A survey designed to identify gaps in laparoscopic training at a single militaryacademic training program was distributed through Google Forms (Google LLC, Mountain View, CA, USA) to general surgery residency and surgical and critical care PA residency programs over a two-week period.The survey included Likert, nominal, and categorical scale questions to collect data on the frequency of individual laparoscopy practice, practice with staff, and perceptions of the benefits of simulated laparoscopic training.The primary data analysis focused on the response rate of answer choices to identify the needs of surgery residents and PA trainees.Results: Twenty-one residents and five PA trainees responded to the survey.Over half of residents (12, 57.1%) responded that they practiced laparoscopic skills independently only one to three times during intern year.Additionally, 11 (52.4%) of the residents never had coached simulated laparoscopic training.All five (100%) of the responding PA trainees have never been instructed on laparoscopic skills or practiced independently.Most participants believe more independent practice (23, 88.5%) and coached practice (25, 96.2%) would benefit their laparoscopic skills as junior trainees.Participants also think more simulated laparoscopic training would impact their autonomy in the operating room (OR) (13 (50%) yes, nine (34.6%) maybe).Conclusions: Despite laparoscopy being integral to surgical practice, over half of surgical trainees have never had formal instruction outside of the OR.The vast majority of respondents expressed a strong belief that additional practice (88.5%) and coaching (96.2%) would be beneficial.This identifies an institutional gap in laparoscopic training and supports consideration of formal, standardized coaching.