Long-term efficacy of a low-cost laparoscopic training curriculum for Nigerian surgeons: 8-month post-course survey

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Abstract Purpose The surgical workforce in Africa is 20 times smaller than the minimum capacity designated by the World Health Organization, resulting in a critical need for enhanced surgical training across the continent. To accompany its open-source laparoscopic training system, ALL-SAFE facilitated a laparoscopic skills training course in Abuja, Nigeria. This study aims to assess the impact of this in-person training program over time by evaluating participant engagement, knowledge and skill acquisition, and use of laparoscopy 8 months after the course. Methods A two-day in-person course was facilitated in October 2023, consisting of didactic lectures and basic skills training in laparoscopic surgery for 32 surgical faculty and trainees from Nigeria. After the course, participants were given sample box trainers and laparoscopic instruments for continued practice and engagement using the ALL-SAFE system. An 8-month post-course survey was created by a multidisciplinary team of surgeons, residents, and researchers and distributed online to all course participants. To assess the impact of the ALL-SAFE training 8 months post-course, questions were framed based on the Consolidated Framework for Implementation Research and the Kirkpatrick Model, Levels 3 and 4, with a focus on the level of engagement in laparoscopic practice, perceived translation of skills to the operating room, and improvements in surgical skills. Results Seventeen participants (17/32 = 53%) completed the survey. Post-course, 88% built their own box trainers or continued using the trainer from the ALL-SAFE course, and 70% continued working with the ALL-SAFE modules, with cognitive learning (50%) and surgical skills training (100%) being the most accessed. Fifty-three percent anticipated continuing to use the modules weekly, and 65% reported increased confidence in performing laparoscopic procedures, with 56% feeling “highly competent.” Additionally, 82% of participants taught laparoscopic skills to colleagues, and 94% noted improvement in their surgical skills, particularly in knot-tying and hand–eye coordination. Seventy-six percent remained “highly satisfied” with the course. Conclusion Eight months after its completion, the in-person ALL-SAFE course in Abuja, Nigeria, demonstrated significant and durable positive outcomes in participant engagement, knowledge expansion, skill acquisition, and sustained use of the training resources. These findings suggest that following the ALL-SAFE course, participants continue to engage in surgical skill development, which has the potential to enhance clinical outcomes. Graphical abstract

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