Journal of the European Society for Gynaecological Endoscopy


Development and validation of a curriculum for laparoscopic supracervical hysterectomy

J.M. Goderstad 1, E. Fosse 2,3, L. Sandvik 4, M. Lieng 3,5

1 Department of Surgery, Sørlandet Hospital, Sykehusveien 1, 4838 Arendal, Norway;
2 The Intervention Centre, Oslo university Hospital, 0424 Oslo, Norway;
3 Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway;
4 Center for biostatistics and epidemiology, Oslo University Hospital, 0373 Oslo, Norway;
5 Division of Obstetrics and Gynecology, Oslo University Hospital, 0424 Oslo, Norway.


Laparoscopy, simulation training, proficiency-based training, certification, curriculum

Published online: Aug 05 2020


Study Objective: To develop and validate a three-step curriculum for laparoscopic supracervical hysterectomy (LSH) designed for a busy clinical setting.

Methods: Single-centre, prospective, cohort study. Twelve eligible gynaecological trainees were included (group 1). The theoretical part (step 1) was a validated multiple-choice test. The practical part (step 2) consisted of five tasks on a virtual reality simulator. The participants had to reach a pre-defined proficiency level before advancing to performing a LSH (step 3). The validation of the curriculum was based on the surgical performance. The surgical procedure was recorded and assessed by two experts using Global Operative Assessment of Laparoscopic Skills (GOALS) and Competence Assessment Tool – Laparoscopic Supracervical Hysterectomy (CAT-LSH). The scores were compared with scores from gynaecological trainees who performed their first LSH without virtual reality simulator training (group 2).

Results: Ten trainees completed the curriculum and performed a LSH that was recorded and evaluated. Mean duration of the training period (step 1 and 2) was 57 days (SD 26.0), and mean training time spent on the simulator to reach the pre-set proficiency level was 173 min (SD 49). The mean GOALS score was 18.5 (SD 5.8) in group 1 and 13.6 (SD 3.3) in group 2, p=0.027. The mean CAT-LSH score of the performance of the hysterectomy was 42.1 (SD 6.9) in group 1 and 34.8 (SD 4.3) in group 2, p= 0.009.

Conclusions: Trainees who completed the curriculum appeared to have a higher performance score compared with trainees who did not perform structured training.