Journal of Surgical Simulation 2022; 9: 31 - 35

Published: 30 March 2022


Original article

Development of an Australasian laparoscopic sleeve gastrectomy curriculum: a content validation study

Ruth E. Blackham and Jeffrey M. Hamdorf
Corresponding author: Ruth E. Blackham, M306, CTEC, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia. Email:


Background: Sleeve gastrectomy is the most performed bariatric procedure in Australia/New Zealand. To date there is no consensus on how the procedure is taught to either trainee surgeons or in the upskilling of general surgeons. To standardize training of the procedure, a laparoscopic sleeve gastrectomy curriculum is required. The aim of this study was to develop content validation for a newly developed laparoscopic sleeve gastrectomy curriculum within the binational context of Australia and New Zealand.

Methods: A survey was conducted via an online platform (Qualtrics). Practising bariatric surgeons who were members of the Australian and New Zealand Metabolic and Obesity Surgery Society (ANZMOSS) were invited to participate. Respondents were required to review the international sleeve gastrectomy curriculum core components. The original 30 items were derived from the clinical practice guidelines, surgical textbooks, and an expert panel in conjunction with the local specialty society. A framework to form Australasian standards was created by linear ranking on a 5-point Likert scale. Components that achieved more than 80% of surgeon consensus of ≥4 or higher were included in the final curriculum.

Results: An invitation was sent to all surgeon members of ANZMOSS, and 41 complete responses were received. The components listed were divided into five domains: anatomic knowledge, patient selection, intra-operative technical considerations, peri-operative considerations and non-technical items. Items ranked ≥4 were used to form a proposed curriculum. Components of the survey informed a formalized task list with 26 individual steps; four did not reach consensus agreement (psychological evaluation, nursing evaluation, technical issues of gastric stapling and buttressing of staple lines). All anatomic knowledge items were agreed upon (>93%). For patient selection, all proposed indications, contraindications and preoperative medical evaluation were agreed upon (>95%), however the inclusion of nursing and psychological evaluation was not supported (<61%). All technical considerations were agreed upon except buttressing considerations, topical agents and omentopexy (<78%). All peri-operative considerations and non-technical items were included.

Conclusions: Utilizing a web-based mixed-methods survey, a comprehensive curriculum for teaching laparoscopic sleeve gastrectomy is proposed. The content of the educational matrix is validated for the Australasian context. Further studies will be required for adaptation of the curriculum before it is used for formalized assessment purposes.


surgery; education; curriculum development; simulation

Supplementary material

Supplementary Table 1 is available at