The Impact of a Laparoscopic Surgery Training Course in a Developing Country

• Published in: World journal of surgery Vol. 44; no. 10; pp. 3284 - 3289
• Main Authors: Westwood, Esther, Malla, Balaram, Ward, Jeremy, Lal, Roshan, Aryal, Kamal
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2020; Springer Nature B.V
• Subjects: Abdominal Surgery; Cardiac Surgery; Careers; Clinical Competence; Computer simulation; Developing countries; General Surgery; Humans; Laparoscopy; Laparoscopy - education; LDCs; Medicine; Medicine & Public Health; Nepal; Qualitative analysis; Questionnaires; Simulation Training; Surgery; Surgery in Low and Middle Income Countries; Thoracic Surgery; Training; Vascular Surgery; Nepal
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-020-05606-y

Introduction Surgeons training junior colleagues to perform laparoscopic surgery find the ‘apprenticeship’ model of surgical training inadequate. Therefore, the use of training courses involving simulation have become an important way to teach laparoscopic surgery. An annual laparoscopic surgery course began in Nepal in 2013. It is difficult to assess the impact of the course on trainees and demonstrate a subsequent improvement in patient outcomes, but one way is to ask delegates for reflections on their experience of the course and their perception of how it has impacted patients. Methods The course involved simulation and patient-based training. A questionnaire to collect quantitative data and qualitative comments was sent to all 80 previous delegates (at least 9 months after the course) in September 2018. Results Twenty-eight delegates responded. The majority demonstrated career progression since completing the course (independent practitioners increased from 7 to 50%) and progression in their practice (18% had performed >20 laparoscopic procedures at the time of the course, vs 70% at the time of the questionnaire). All delegates felt that laparoscopic training is useful in the Nepalese context. Delegates felt the course was useful in developing skills, and improving confidence and safety. Suggestions for improvement included lengthening the course and increasing the amount of practical exposure. Conclusion There was a positive outcome of the course to Kirkpatrick level 2. There is a need to expand the course’s scope to an advanced level, increase its length and start courses in other centres, to ensure the most possible benefit to patients.