Pilot implementation of a structured laparoscopic suturing training program: Effects on resident confidence
Keeran Bonia, Stephen Quigley MD MAS FRCSC, Alex Mathieson MD FRCSC, Bradley Evans MD MSc FRCSC
Memorial University of Newfoundland
Introduction
-Laparoscopic suturing is a critical skill for general surgery residents.
-No structured laparoscopic suturing curriculum currently exists at our institution.
-The operating room is a challenging learning environment for complex technical skills, due to time constraints, limited feedback, and patient safety priorities.
-Evaluate whether our structured laparoscopic suturing simulation program improves general surgery residents’ confidence in performing laparoscopic suturing.
Methodology
Participants
-General surgery residents at Memorial University.
-13 residents completed pre-training survey.
-7 residents completed paired pre- and post-training surveys.
Training Program
-5-month pilot simulation curriculum.
-Monthly 1-hour sessions using laparoscopic box trainers.
-Residents freely practiced skills derives from FLS tasks.
-Staff surgeons provided real-time feedback and instruction.
Evaluation
-Pre-training and post-training questionnaires.
-Resident confidence in laparoscopic suturing assessed.
-Paired analysis using Wilcoxon signed-rank test.
Results
Resident Self-Reported Confidence
-Median confidence increased from 1 (IQR 1–2) to 2 (IQR 2–3).
-Median increase: 100%
-Statistically significant improvement (p = 0.027).
Participation
-Median attendance: 4 of 5 sessions.
-Most residents reported minimal independent laparoscopic suturing practice outside clinical exposure.
Qualitative Feedback
Participants reported:
-Improved technical fluency.
-Increased confidence with laparoscopic suturing.
-Value of dedicated simulation time with staff supervision.
Conclusion
-A structured laparoscopic suturing simulation program is feasible and well received by residents.
-Participation was associated with significant improvement in resident confidence performing laparoscopic suturing.
-The pilot identified a clear need for protected simulation training within the residency curriculum.
Future Direction
-Monthly protected daytime simulation sessions have now been implemented in the residency schedule.
-The next phase of the project is funded and in-progress.
-Phase 2 includes video-based evaluation of bowel anastomosis technical performance using blinded staff assessment.