| Summary: | Laparoscopic bariatric procedures are complex minimally invasive operations with a potential
for substantial morbidity and mortality along the early part of a surgeon’s learning curve.
Simulation-enhanced training can improve a surgeon's technical and non-technical performance
and lessen the learning curves in the operating room. Unfortunately, despite the convincing
evidence supporting the use of simulation in surgical education, there is still a gap in translation
of knowledge and technical skills from the research environment into clinically relevant training
curricula. The objective of this thesis was to design and validate a comprehensive simulationenhanced
training curriculum that addressed cognitive knowledge, technical and non-technical
skill in laparoscopic bariatric surgery. This objective was achieved using three experimental
studies. The first study employed a modified Delphi methodology and an international panel of experts in
surgical and medical education to develop a consensus-based framework for design, validation
and implementation of simulation-enahnced training curricula in surgery. The second study used
a modified Delphi methodology and an international panel of experienced bariatric surgeons to develop an objective scale for assessment of operative skill in laparoscopic gastric bypass procedure. This scale was feasible to use and had high inter-rater and test-retest reliability, as
well as evidence of construct and concurrent validity.
The third study used the previously developed consensus-based framework to design a
comprehensive simulation-enhanced training curriculum for laparoscopic bariatric surgery. A
prospective, single-blinded randomized controlled trial was used to compare the effectiveness of
this curriculum in comparison to conventional surgery training. Surgery residents who were
trained in this curriculum demonstrated superior technical skills, superior non-technical skills
and enhanced safety in the operating room.
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