First Advisor

Donn H. Spight

Date of Award


Document Type


Degree Name

Bachelor of Science (B.S.) in Science and University Honors




Laparoscopic surgery -- Study and teaching -- Evaluation, Surgery -- Standards -- Evaluation, Surgery -- Study and teaching (Residency) -- Case studies, Surgeons -- Training of -- Case studies




As the field of medicine, especially surgery, progresses, new challenges in the training of physicians have emerged. While surgical education has been traditionally structured as an apprenticeship-based model, this has proven to be time consuming, costly, and unethical to patients, physicians, and medical institutions alike. One solution that has arisen due to the need for balancing safety with education is the usage of simulation-based training. Simulation has become an accepted and valued way of training physicians due to its assurance of safe, scheduled, targeted, and objective training for the learner, as well as safe and efficient clinical experiences for patients.

Oregon Health and Science University (OHSU), along with every other accredited surgical residency program in the United States, has integrated a skills lab into their general surgery curriculum due to a 2008 mandate issued by the Accreditation Council for Graduate Medical Education (ACGME). The surgical simulation skills lab at OHSU is titled VirtuOHSU. A core part of VirtuOHSU’s curriculum involves the training of basic laparoscopic skills. As simulation-based training was established, there was not a clear development of a standardized training curriculum for laparoscopic surgery and thus there has been a significant gap in the discourse’s understanding of what proficiency metric is considered adequate for laparoscopic surgery training.

In 2008, the OHSU general surgery residency program adopted proficiency levels from a study done by Drs. E. Matt Ritter and Daniel J. Scott of the University of Texas Southwestern Medical Center. For the past six years, VirtuOHSU has used these standards to evaluate their general surgery residents. The goal of this paper was to evaluate the validity of the standard used at VirtuOHSU. My research suggests, that due to the arbitrary nature of these standards, the current proficiency benchmarks are not an effective way of evaluating the skill level of surgical residents trained at OHSU.

In July 2014, OHSU’s Department of Surgery will adopt the ACGME Milestones Project and moving forward with this project it will be necessary to determine what is acceptable competency standards for laparoscopic surgery training. The results found, in the data collection part of this work, guided the creation of new laparoscopic proficiency benchmarks for each program year level of general surgery residents. In the future, the correlation between simulation skills lab performance and actual operative performance will be examined.


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