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Advanced Training in Laparoscopic Suturing (ATLAS) is feasible and addresses the transferability gap

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Global Surgical Education - Journal of the Association for Surgical Education Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to assess the feasibility and transferability of skills acquired using the Advanced Training in Laparoscopic Suturing (ATLAS) curriculum for novice trainees.

Methods

First-year medical students (n = 20) pre-tested on Fundamentals of Laparoscopic Surgery (FLS), ATLAS, and a Porcine Laparoscopic Nissen (PLN) model and were subsequently randomized into training and control groups. The training group trained to proficiency on FLS followed by post-test 1 (FLS/ATLAS/PLN), followed by proficiency-based ATLAS training and post-test 2 (FLS/ATLAS/PLN). The control group received no training and post-tested concurrently. Data are reported as median [interquartile range].

Results

There were nine dropouts; data were analyzed for training (n = 6) and control (n = 5) participants who completed the study. There were no significant differences between groups at baseline for overall pre-test and each subcomponent (p > 0.05). FLS training took 9.6 [7.6–11.6] hours, and ATLAS training 15.9 [13.9–25.8] hours. FLS training resulted in significant performance improvements in the overall and FLS scores versus controls. After ATLAS training, there was significant improvement in performance for the overall, FLS, ATLAS, and PLN scores versus controls. Workload was significantly higher for ATLAS compared to FLS training; however, ratings for curriculum appropriateness were similar.

Conclusions

This study demonstrated that proficiency-based ATLAS training was feasible with all training group participants achieving proficiency after a reasonable amount of time. Importantly, ATLAS training was associated with significant performance improvement following FLS training as measured by a live porcine model. These findings support further investigations and more widespread ATLAS adoption.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors gratefully acknowledge support provided by the UT Southwestern Simulation Center. We would also like to thank the medical students who volunteered their time to participate in this study.

Funding

No funding received.

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Authors and Affiliations

  1. Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9159, USA

    Madhuri B. Nagaraj, Kyle Langston & Daniel J. Scott

Authors
  1. Madhuri B. Nagaraj
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  2. Kyle Langston
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  3. Daniel J. Scott
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Corresponding author

Correspondence to Madhuri B. Nagaraj.

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We have no financial conflicts of interest to disclose.

Appendices

Appendix A

See (Table 4)

Table 4 ATLAS curriculum errors and value
Full size table

Appendix B

See (Table 5)

Table 5 Trained arm testing results for individual subjects
Full size table

Appendix C

See (Table 6)

Table 6 Control arm testing results for individual subjects
Full size table

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Nagaraj, M.B., Langston, K. & Scott, D.J. Advanced Training in Laparoscopic Suturing (ATLAS) is feasible and addresses the transferability gap. Global Surg Educ 2, 15 (2023). https://doi.org/10.1007/s44186-022-00072-7

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  • DOI: https://doi.org/10.1007/s44186-022-00072-7

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