The effect of a simple intraprocedural checklist on the task performance of laparoscopic novices

Background: Surgical checklists are used for error reduction. Checklists are infrequently applied during procedures and have been limited to lists of procedural steps as aid memoires. We aimed to study the effect of a self-administered checklist on the laparoscopic task performance of novices during a standardized task. Methods: Twenty novices were randomized into two equal groups, those receiving paper feedback (control group), and those receiving paper feedback and the checklist (checklist group). Subjects performed laparoscopic double knots, repeated over 5 separate stages. Human reliability assessment technique was used for error analysis. Results: 2,341 errors were detected during the 5 stages. During the first stage, the errors were not significantly different between the two groups. The checklist group committed significantly fewer errors as compared to the control group during all the later 4 stages (p<0.01). Conclusions: The simple intra-procedural checklist significantly improved the laparoscopic task performance and the learning curve of laparoscopic novices.