What laparoscopic skills are necessary for Certificate of Completion of Training? : A prospective nationwide cross-sectional survey of Obstetrics & Gynaecology and General Surgery trainees and consultants in the UK

Abstract

Objectives: To explore the views of Obstetrics & Gynaecology (O&G) and General Surgery (GS) trainees and consultants on the laparoscopic skills considered necessary to achieve the Certificate of Completion of Training (CCT) and identify any mismatch between consultants and trainees in their expectations of these skills. Design: A prospective nationwide cross-sectional study in the UK. Setting: A national survey distributed through Health Education, England and national training bodies such as the Royal College of Obstetricians & Gynaecologist (RCOG), British society for gynaecological endoscopy (BSGE) and the Association of Surgeons of Great Britain and Ireland (ASGBI). Participants: O&G and GS consultants and specialty trainees in O&G and GS. Specialty trainees below ST3 level and consultants performing open surgery or minor laparoscopic surgery only were excluded. Interventions: Trainees completed a 27-item questionnaire on their training characteristics, rated their confidence and perceived importance of 10 laparoscopic skills required for CCT using a 5-point Likert scale. Consultants answered a 36-item questionnaire on their demographic details, their views on the importance of the same 10 laparoscopic skills, their confidence and the standard of laparoscopic skills they observed amongst trainees approaching CCT. Results: 345 participants responded to the questionnaire: 117 O&G trainees, 95 O&G consultants, 57 GS trainees & 76 GS consultants. O&G trainees and consultants expected similar laparoscopic skills required for CCT for all ten skills (P> 0.050), whilst GS consultants had higher expectations of GS trainees for suturing (P=0.003), use of endovascular devices (P=0.020) and staplers (P=0.020). Consultants in both specialties observed that trainees were performing significantly below the expected standards; P< 0.010 (O&G) and P<0.001 (GS) for all 10 listed skills. O&G trainees reported lower confidence than GS trainees for all 10 laparoscopic skills (P<0.001). Conclusions: This nationwide study showed that UK O&G trainees and consultants both agree on the skills required for CCT, but GS consultants had higher expectations than their trainees. Trainees in GS were more confident in their surgical skills than those in O&G. However, consultants in both specialities believed that trainees were not achieving the requisite laparoscopic skills required for CCT