Background
Specialty trainees need effective methods for learning important procedures in minimal access surgery, there is a need to learn and practice those skills initially in a way that does not include direct patient involvement. To improve the clinical orientation process for specialty trainees in obstetrics and gynaecology, Thames Valley Deanery holds an annual gynaecology laparoscopic simulation day. We mainstreamed a training pathway for an essential minimal access procedure and analyzed the change in trainees’ attitudes toward this procedure following a 2 stage teaching process. 

Summary of Work
Laparoscopic salpingectomy for ectopic pregnancy, is a key operation considered necessary to treat potentially life-threatening ruptured tubal pregnancy. We divided teaching this procedure over 2 separate stages; first stage was during video-based seminar, where the procedure was broken down into 6 simple steps in a ten-minute video presentation. Prior to commencing hands on practice on laparoscopic simulation box, trainees were given primary questionnaire to assess their knowledge of the steps of the procedure; confidence to perform the procedure independently; and ability to teach the steps of the procedure. The second stage was hands on practice on simulation box where 2 trainees assumed 2 separate roles; a candidate performing the procedure and an examiner assessing performance of the candidate based on the precedent 6 steps of the procedure. Following simulation box “candidate-examiner“ practice, trainees were given secondary questionnaire to rate their knowledge of the steps to perform the procedure, confidence to perform it independently, and ability to teach the steps of the procedure. The aim was to analyze the change in trainees’ attitudes towards this procedure following the lap simulation training day. 

Summary of Results
20 specialty trainees’ years 3 to 5 attended this simulation day, 13 trainees completed questionnaires for this 2-stage training. Using Mann-Whitney U test, we analyzed the change in trainee’s knowledge of the steps of the procedure, change in their confidence to perform it independently, and change in their ability to teach it. The average knowledge of the steps to perform salpingectomy showed the largest rise from 5.3 to 7.6, with a significant 2.3 increase (p value