Effect of Curriculum II, and Bifacial Accreditation on the Outcome of Trainees in a Course of Laparoscopy in Al Sulaimaneyah City /Iraq

Abstract

Background; The use of laparoscopic surgical procedures without previous training has grown rapidly over the last decade. At the same time, there have been allegations of increased complications among less experienced surgeons.  As with other surgical procedures, a period of learning is required, especially when new techniques are involved. Aims; to evaluate accreditation of laparoscopic training for inexperienced surgical trainees Trainees, materials and methods; As information based, step by step method of training with supervision and feedback in every step we commence the practical part of the course. Instruments were familiarized in a session, and the procedure was fully demonstrated by an experienced surgeon step by step, then  dry laboratory on animated boxes, with an opportunity for the trainees to ask questions was arranged . In the wet laboratory,  the trainees were observed by experienced laparoscopist ,who was not always scrubbed in, checking and recording the steps of the procedure Results; Most of the trainees were male with female to male ratio of 1/5, age ranging from (28 to 37) years, with median age of 31 years .Most of them were 3rd year trainees of Iraqi board of medical specialty –surgery and were inexperienced in laparoscopy After completion of the course we distributed a questionnaire to the trainees, to validate the items of the course, personal satisfaction, fatigue and perceived changes in knowledge and skills, and practice Conclusion; the knowledge based learning, a stepwise technical skills in curriculum II, with on spot feedback   will teach practical skills for inexperienced surgical trainees ,but they need more training by clinical attachment and assisting in laparoscopy on real patients in the form of curriculum III to be qualified as laparoscopic surgeons. So it is better that training of laparoscopy to be incorporated as early as third year in to the curriculum of training programs for trainees of board of surgery, to give time for further training before qualification as surgeons. Key words; training, laparoscopy, curriculum, dry lab, wet lab