O-GYN-MD-071 Implementation and Validation of a Retroperitoneal Dissection Curriculum

Competency-based education requires educators to use simulation training to increase residents’ exposure to various procedures. The ability to identify the ureter surgically is a fundamental skill for gynaecologists. Our goal was to validate a comprehensive curriculum for laparoscopic retroperitoneal dissection (LRD). A comprehensive curriculum to teach laparoscopic ureterolysis was designed encompassing didactic and technical skill components using a previously developed pelvic model. Novice surgeons (PGY 3-5) were recruited. Subjects underwent pre- and post- curriculum multiple-choice questionnaires (MCQ) to evaluate the knowledge component. Pre- and post- performance on the model was video-recorded. As part of the technical component, participants received constructive feedback on how to perform LRD from expert surgeons. Participants were video-recorded performing LRD in the operating room within 3 months of the curriculum. All videos were blindly assessed by an expert using the objective structured assessment of technical skills (OSAT) tool. Thirty novice gynaecologic surgeons were recruited. Knowledge of ureteric anatomy and injury was high at baseline (mean MCQ pre 6.55 ± 1.50), but improved following the curriculum (mean MCQ post 8.03 ± 1.12, P < 0.001). The improvement in technical scores on the model was statistically significant (mean OSAT pre 25.50 ± 3.20, mean OSAT post 30.07±2.97, P < 0.001). Video recordings were completed for 21 participants. Intraoperative OSAT scores (mean 29.76 ± 2.74) correlated with post-training OSAT scores (r = 0.53, P = 0.01). The ureter was identified intraoperatively by 90% of participants. A comprehensive retroperitoneal dissection curriculum showed improvement in cognitive knowledge and technical skills, which translated to competent performance in the operating room.