Silo Placement in Gastroschisis: A Pilot Study of Simulation-based Training for General Surgery Residents
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In brief
In brief
This pilot study demonstrates that simulation-based training significantly improves general surgery residents' confidence and technical proficiency in placing silastic silos for gastroschisis, a high-acuity low-volume pediatric procedure. Ten PGY-3 residents showed sustained improvement over three months, with increased proficiency rates and confidence scores across all procedural steps.
Written by the GCMD Library team from the article.
Abstract
Introduction
General surgery residents often feel unprepared for rotations on pediatric surgical services as case volume and experience performing pediatric procedures may be inadequate for high acuity, low volume procedures. We designed a single institution pilot study to assess whether simulation-based training (SBT) for placement of a silastic silo for gastroschisis was feasible and lead to skill acquisition, retention and increased resident confidence.
Methods
We used our newly created gastroschisis module within our pediatric surgery SBT curriculum for general surgery residents. Residents completed two simulation sessions three months apart, completed confidence testing before and after each session, and were assessed using a standardized case scenario and procedure checklist. Wilcoxon Signed-Rank Tests evaluated changes in residents' confidence and performance.
Results
Ten post-graduate-year three general surgery residents completed this curriculum. Residents reported improved confidence completing each step of the procedure initially (p=0.008) and at 3 months (p=0.005). They had improved technical scores across all steps of the procedure (p=0.005). The number of residents deemed proficient significantly improved (p=0.008).
Conclusion
We demonstrated the feasibility of assessing the technical skills of general surgery residents performing a simulated placement of a silastic silo for gastroschisis. Residents' confidence and proficiency improved over the three-month period.
Study Type
Prospective
Level of Evidence
Level II