Journal of Surgical Simulation 2023; 10: 43 - 53

Published: 30 December 2023


Original article

Developing a formal curriculum on basic open and laparoscopic skills in a new community hospital general surgery residency program with limited simulation resources

Dylan Johnson, Tenzin Atruktsang, Dinesh Kumar, Cristiano Alpendre, Darshan Thakkar and Thomas Abbruzzese
Corresponding author: Dylan Johnson, HCA Florida Brandon Hospital General Surgery Residency Program, Department of General Surgery, HCA Healthcare/USF Morsani College of Medicine Graduate Medical Education, 119 Oakfield Drive, Brandon, FL 33511, USA. Email:


Background: There is little information in the literature with regard to the development of simulation curricula within new general surgery residency programs, especially those based in community hospitals with limited simulation resources and experience in graduate medical education. As members of a new surgery residency program at such a community hospital, with limited resources, we aimed to implement a formal simulation curriculum on basic open and laparoscopic surgical skills, quantify the progress of trainees over the course of a single academic calendar year, and describe our experience.

Methods: To implement a formal simulation curriculum, in collaboration with the surgeon faculty, a team of trainees developed a schedule of simulation topics to occur throughout the academic year. The team also devised a set of simulation exercises to evaluate trainee performance throughout the year using improvised materials. Junior residents participated in testing sessions where they completed these tasks and data were recorded. At the end of the academic year, data were analyzed to evaluate changes in trainee performance throughout the year.

Results: A total of 16 junior trainees participated in the simulation testing sessions throughout the year. By the end of the academic year, time to completion decreased significantly in three of the four suturing tasks, while qualitative scores increased in all four tasks. There was significant improvement in time to completion for two of the five laparoscopic tasks. While there was a trend towards increasing scores, only one laparoscopic task had significant improvement in qualitative scoring by the end of the year.

Conclusions: Even with limited resources, the implementation of a structured simulation program can result in objective improvements in surgical trainee performance.


surgical; simulation; development; residency; program; limited resources

Supplementary material

Supplementary files 1–4 are available at:
Supplementary file 1. Instructions for suturing tasks.
Supplementary file 2. Instructions for laparoscopic tasks.
Supplementary file 3. Scoring sheets for suturing tasks.
Supplementary file 4. Scoring sheets for laparoscopic tasks.