The application of the BOPPPS model in the ward rounds of nurses' standardized training in Southwest China: a mixed methods study.

Background: Teaching ward rounds are the main teaching method used to develop clinical skills in standardized nursing training. However, the existing methods lack of cultivation of comprehensive ability and humanistic care for nurses, cannot meet the requirements of standardized training for nurses. BOPPPS (bridge-in, objective, pre-assessment, participatory Learning, post-assessment, and summary) is a student-centered teaching model that has been proven to enhance classroom teaching effectiveness. Therefore, the BOPPPS model was applied and its effectiveness in standardized nursing training was evaluated. Methods: In total, 260 nursing students were randomly allocated to two groups: the experimental group used the BOPPPS model and the control group used the traditional teaching model. This study used a mixed quantitative and qualitative research method to evaluate the effectiveness of the BOPPPS model. Results: The quantitative results were as follows: no significant difference in baseline scores was observed between the two groups before training. After training, the theory and practical scores in the experimental group were significantly higher than that of the control group. Similarly, students in the experimental group presented higher comprehensive ability scores than their counterparts. The students in the experimental group also exhibited higher satisfaction compared to the control group, while there was no difference in teacher satisfaction scores between the two groups (p = 0.323). Qualitative data showed that the vast majority of nurses and teachers agreed on the value of BOPPPS training. Conclusion: Compared to traditional teaching methods, the BOPPPS model was more effective in standardized nursing training. We recommend applying the BOPPPS model to nursing training.

The early career resilience experience of generation Z newly graduated registered nurses in standardized training in the emergency department: a qualitative study in Shanghai.

BACKGROUND: The period of standardized training is a transitional stage when Generation Z newly graduated registered nurses (Gen Z NGRNs) change their role from student to nurse. Affected by the COVID-19, they lack clinical practice and practicum experience in emergency departments in their university studies. At the beginning of career, they are under great pressure. Resilience is one of the factors that reduce their stress level and increases endurance. It is of interest to understand how this representative group of nurses gained and played the experience of resilience early in their careers. OBJECTIVE: To explore Gen Z NGRNs' experience and process of resilience, to provide a new perspective and theoretical basis for psychological rehabilitation or intervention of medical staff who experienced transition shock. METHODS: This study employed a qualitative design based on the phenomenological approach. 18 nurses from a third-level class-A hospital in Shanghai who participated in standardized training in emergency department were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. RESULTS: The investigation uncovered three themes and ten subthemes. Pressure and challenge contained high workload and high risk coexist, death's stress response, more emergencies and high professional requirements. Coping and adaptation contained team help, psychological restructuring, peer support, transformational leadership. Reflection and planning contained enhance learning, appreciate life. CONCLUSIONS: Our study described the embodiment and coping experience of the physical and mental stress faced by Gen Z NGRNs during their standardized training in the emergency department. It is emphasized that nurse educators should pay attention to the character and actual needs of Gen Z NGRNs, explore and formulate strategies, so as to guide NGRNs to quickly adapt and grow in the new role. The ultimate goal is to increase nurse retention and improve the quality of nursing.

A survey on brachytherapy training of gynecological cancer focusing on the competence of residents in China.

BACKGROUND: The brachytherapy is an indispensable treatment for gynecological tumors, but the quality and efficiency of brachytherapy training for residents is still unclear. METHODS: An anonymous questionnaire was designed to collect information on gynecological brachytherapy (GBT) training for radiation oncology residents from 28 training bases in China. The questionnaire content was designed based on the principle of competency based medical education (CBME). The Likert scale was employed to evaluate self-reported competence and comprehension regarding GBT. A total of 132 senior residents were included in the final analysis. RESULTS: 53.79% (71/132) of senior residents had experience in performing image-guided GBT, whereas 76.52% (101/132) had observed the procedure during their standardized residency training. The proportion of senior residents who reported having the self-reported competence to independently complete the GBT was 78.03% for intracavity GBT, 75.00% for vaginal stump GBT, and 50.03% for interstitial GBT, respectively. The number of successful completion of Interstitial, intracavity and vaginal GBT was correlated with the self- confidence of trainees after standardized training. In particular, the independent completion of interstitial GBT for more than 20 cases was an independent factor for the self-reported competence of senior residents. During the training period, 50.76% and 56.82% of the residents had not participated in the specialized examinations and professional GBT courses. CONCLUSIONS: The study revealed that the self-confidence of residents to independently complete brachytherapy was relatively high, and the specialized curriculum setting and training process assessment for brachytherapy training still need to be strengthened in the future.

Application of online to offline teaching mode in the training of non-anesthesiology residents in the department of anesthesiology: a randomized, controlled trial.

Objective: To explore the effect of applying the online to offline teaching mode in the training of non-anesthesiology residents in department of anesthesiology. Trial design: The randomized controlled trial was performed on non-anesthesiology residents from Affiliated Jiangning Hospital of Nanjing Medical University. Methods: All selected residents were randomly divided into the traditional teaching group (Group T) and the online to offline teaching group (Group O) by the random number table method. Traditional teaching mode was used in Group T, while the online to offline teaching mode was used in Group O. The training period lasted for two months. At the end of the training, theoretical and clinical skills were assessed for all residents, and students' satisfaction scores on teaching were investigated from the aspects of teaching mode, stimulating learning interest, improving learning process and teaching satisfaction. The teaching efficiency was compared and analyzed in the two groups. Results: In total, 39 cases in Group O and 38 cases in Group T were included in the statistical analysis. Compared with Group T, theory test scores, clinical skills test scores, and overall scores improved significantly in Group O (82.2 ± 8.1 vs. 91.3 ± 7.6; 85.1 ± 4.7 vs. 93.3 ± 5.4 and 83.4 ± 6.4 vs. 92.1 ± 6.7, respectively, p < 0.01). Compared with Group T, scores on teaching mode, stimulating learning interest, improving learning process and teaching satisfaction were higher in Group O (81.1 ± 6.9 vs. 93.7 ± 5.2; 83.6 ± 5.8 vs. 91.6 ± 6.4; 82.4 ± 5.3 vs. 90.9 ± 4.8 and 82.1 ± 5.9 vs. 92.1 ± 5.5, respectively, p < 0.01). Conclusion: The online to offline teaching mode can improve the level of professional theory and clinical skill operation, and teaching satisfaction of the non-anesthesiology residents in department of anesthesiology, thus improving the teaching effectiveness.

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Gastrointestinal (GI) endoscope is one of the instruments used extensively in the diagnosis and treatment of digestive tract disorders. China is confronted with a great demand for endoscopists working in grassroots healthcare facilities. Furthermore, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS), and endoscopic submucosal dissection (ESD) are becoming the prevailing methods of endoscopic treatment of digestive diseases. Therefore, there is a growing demand for senior endoscopists. Currently, an important focus of GI endoscopy training is the acceleration of standardized training for endoscopists working in grassroots health facilities and advanced training for senior endoscopists. Simulation devices based on virtual reality technology exhibit strengths in objectivity, authenticity, and an immersive experience. These devices show advantages in the training method, the number of participants, and assessment over traditional training programs for GI endoscopy. Their application provides a new approach to the training and teaching of GI endoscopy. Herein, we summarized the explorations and practices of using virtual reality technology in the training and teaching of GI endoscopy, analyzed its application status in China, and discussed its prospects for future application.

Application of flipped classroom teaching method based on ADDIE concept in clinical teaching for neurology residents.

BACKGROUND: As an important medical personnel training system in China, standardized residency training plays an important role in enriching residents' clinical experience, improving their ability to communicate with patients and their clinical expertise. The difficulty of teaching neurology lies in the fact that there are many types of diseases, complicated conditions, and strong specialisation, which puts higher requirements on residents' independent learning ability, the cultivation of critical thinking, and the learning effect. Based on the concept of ADDIE (Analysis-Design-Development-Implementation-Evaluation), this study combines the theory and clinical practice of flipped classroom teaching method to evaluate the teaching effect, so as to provide a basis and reference for the implementation of flipped classroom in the future of neurology residency training teaching. METHODS: The participants of the study were 90 neurology residents in standardised training in our hospital in the classes of 2019 and 2020. A total of 90 residents were divided into a control group and an observation group of 45 cases each using the random number table method. The control group used traditional teaching methods, including problem based learning (PBL), case-based learning (CBL), and lecture-based learning (LBL). The observation group adopted the flipped classroom teaching method based on the ADDIE teaching concept. A unified assessment of the learning outcomes of the residents was conducted before they left the department in the fourth week, including the assessment of theoretical and skill knowledge, the assessment of independent learning ability, the assessment of critical thinking ability, and the assessment of clinical practice ability. Finally, the overall quality of teaching was assessed. RESULTS: The theoretical and clinical skills assessment scores achieved by the observation group were significantly higher than those of the control group, and the results were statistically significant (P < 0.001). The scores of independent learning ability and critical thinking ability of the observation group were better than those of the control group, showing statistically significant differences (P < 0.001). The observation group was better than the control group in all indicators in terms of Mini-Cex score (P < 0.05). In addition, the observation group had better teaching quality compared to the control group (P < 0.001). CONCLUSION: Based on the concept of ADDIE combined with flipped classroom teaching method can effectively improve the teaching effect of standardized training of neurology residents, and had a positive effect on the improvement of residents' autonomous learning ability, critical thinking ability, theoretical knowledge and clinical comprehensive ability.

Development and testing of a post competency scale for traditional Chinese medicine physicians undergoing standardized training.

Objective: To develop and test a post competency scale for traditional Chinese medicine (TCM) physicians undergoing standardized training to provide an applicable tool for scientific evaluation. Methods: Based on literature analysis, behavioral event interviews, and expert consultations, measurement questions were formulated and the initial scale was designed. A questionnaire survey was conducted from July 2022 to May 2023 among TCM physicians undergoing standardized training in China. The rationality of the scale was confirmed through item purification, factor analysis, and tests of reliability and validity. Results: The post competency scale consisted of three dimensions (TCM fundamentals and research abilities, TCM thinking and skill abilities, and personal traits and communication abilities) with 21 items. Exploratory factor analysis identified three common factors, accounting for a cumulative variance contribution rate of 62.165%. Confirmatory factor analysis demonstrated that the fit indices of the three-factor model fell within a relatively ideal level. The Cronbach's alpha coefficient of the scale was 0.885. Through convergent validity analysis, the standardized loading coefficients of the 21 items were >0.5, and the average extracted variance (AVE) of the three factors was also >0.5. Moreover, the square roots of the AVE values for each dimension exceeded the correlation coefficients between it and the other dimensions. Conclusions: The findings suggest that the post competency scale of TCM physicians undergoing standardized training can provide a reliable scientific basis for training and assessment within China.

Application of practice-based learning and improvement in standardized training of general practitioners.

BACKGROUND: In the context of standardized training for general practitioners, the emphasis is still primarily on clinical skills, which does not fully encompass the overall development of general practitioners. This study implemented a practice-based learning and improvement (PBLI) project among students and evaluated its effectiveness based on indicators such as learning outcomes, students' subjective experiences, and annual grades. This study offers recommendations for optimizing general practitioners' teaching and residential training programs. METHODS: 60 residents who participated in the regular training of general practitioners at the First Clinical College of Tongji Medical College of Huazhong University of Science and Technology from January 2019 to January 2022 were selected for this study. They were randomly divided into two groups, the PBLI group, and the control group, using a random number table method. Out of the 60 residents, 31 were assigned to the control group and 29 were assigned to the PBLI group. The participants in the PBLI group received additional PBLI training along with their daily residential training, while the participants in the control group only took part in the latter. The effectiveness of the PBLI program was analyzed by conducting a baseline survey, administering questionnaires, and evaluating examination results. RESULTS: After implementing the program, the PBLI group scored significantly higher than the control group (p < 0.05). Throughout the implementation process, students in the PBLI group expressed high satisfaction with the learning project, particularly with its content and alignment with the training objective. The teacher's evaluation of the PBLI group students surpassed that of the control group in various areas, including literature retrieval, self-study, courseware development, speech ability, and clinical thinking. CONCLUSIONS: The PBLI program aims to encourage resident-centered study in standardized residency training. This approach is beneficial because it motivates students to engage in active learning and self-reflection, ultimately enhancing the effectiveness of standardized residency training.

Research on the Role of Innovative Interactive Medical Humanities Education in Standardized Training for Pediatric Residents / 中国医学伦理学

The cultivation of medical humanistic quality is indispensable in the standardized training of pediatric residents, and it is urgent to explore new educational methods to improve their medical humanistic quality level. In this study, 60 standardized pediatricians participated in the standardized training, 36 in the experimental group received innovative interactive medical humanities education, while 24 in the control group were set up to receive traditional medical humanities education. Short-term and long-term test scores were conducted by questionnaire at the beginning of the standardized training and 2 years later. The results showed that there was no significant difference between the experimental group and the control group in the self-scores of professional quality, moral cultivation, communication skills, legal knowledge and innovative spirit (P>0.05) , but the scores of teaching teachers were improved except innovative spirit (P<0.05) . In addition, compared with the control group, the number of pediatricians with professional honor increased, the doctor-patient communication ability improved, the medical disputes reduced, and the family satisfaction improved in experimental group were increased (P<0.05) . These results indicated that innovative interactive medical humanistic education is an effective method to improve the medical humanistic quality of pediatric residents in standardized training.

Multi-center, pragmatic, cluster-randomized, controlled trial of standardized peritoneal dialysis (PD) training versus usual care on PD-related infections (the TEACH-PD trial): trial protocol.

BACKGROUND: Peritoneal dialysis (PD)-related infections, such as peritonitis, exit site, and tunnel infections, substantially impair the sustainability of PD. Accordingly, PD-related infection is the top-priority research outcome for patients and caregivers. While PD nurse trainers teach patients to perform their own PD, PD training curricula are not standardized or informed by an evidentiary base and may offer a potential approach to prevent PD infections. The Targeted Education ApproaCH to improve Peritoneal Dialysis outcomes (TEACH-PD) trial evaluates whether a standardized training curriculum for PD nurse trainers and incident PD patients based on the International Society for Peritoneal Dialysis (ISPD) guidelines reduces PD-related infections compared to usual training practices. METHODS: The TEACH-PD trial is a registry-based, pragmatic, open-label, multi-center, binational, cluster-randomized controlled trial. TEACH-PD will recruit adults aged 18 years or older who have not previously undergone PD training at 42 PD treatment units (clusters) in Australia and New Zealand (ANZ) between July 2019 and June 2023. Clusters will be randomized 1:1 to standardized TEACH-PD training curriculum or usual training practice. The primary trial outcome is the time to the first occurrence of any PD-related infection (exit site infection, tunnel infection, or peritonitis). The secondary trial outcomes are the individual components of the primary outcome, infection-associated catheter removal, transfer to hemodialysis (greater than 30 days and 180 days), quality of life, hospitalization, all-cause death, a composite of transfer to hemodialysis or all-cause death, and cost-effectiveness. Participants are followed for a minimum of 12 months with a targeted average follow-up period of 2 years. Participant and outcome data are collected from the ANZ Dialysis and Transplant Registry (ANZDATA) and the New Zealand Peritoneal Dialysis (NZPD) Registry. This protocol follows the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. DISCUSSION: TEACH-PD is a registry-based, cluster-randomized pragmatic trial that aims to provide high-certainty evidence about whether an ISPD guideline-informed standardized PD training curriculum for PD nurse trainers and adult patients prevents PD-related infections. TRIAL REGISTRATION: ClinicalTrials.gov NCT03816111. Registered on 24 January 2019.

Study on a job competence evaluation system for resident physicians (including integrated postgraduates) receiving standardized training.

BACKGROUND: Standardized training for resident physicians is the primary form of postgraduate medical education, and it plays a pivotal role in healthcare safety and industry stability. Currently, it has garnered significant attention from healthcare institutions. METHODS: By conducting a comprehensive literature review and a Delphi consultation in June 2022 for which 40 experts in clinical medicine, public health, and other related fields in China were invited. The indicators were adjusted according to the results of the consultation, and the final indicator weights were determined through an analytic hierarchy process. RESULTS: The response rate was 100%, and the expert authority coefficient was 0.879. The consistency among the experts on the tertiary indicators, as measured by Kendall's W, was 0.675 (χ2 = 42.516, p < 0.001). Based on the results of the expert consultation, a job competence evaluation system for resident physicians (including integrated postgraduates) receiving standardized training was established, which included 6 primary indicators, 18 secondary indicators, and 116 tertiary indicators. The weights for the primary indicators, namely professional quality, skills and knowledge, patient care, communication and collaboration, teaching skills, and lifelong learning, were 0.313, 0.248, 0.181, 0.083, 0.066, and 0.110, respectively. The top three secondary indicators in terms of combined weights were clinical skills (0.122), professional ethics (0.120), and professional dedication (0.109). The three tertiary indicators with the highest scores were "maintains collaboration with peers and colleagues in patient treatment," "has clinical thinking skills, makes diagnosis and treatment decisions based on analysis of evidence, and has the ability to administer suitable treatments," and "abides by laws and discipline and refuses to seek personal gains in medical practice"; their combined weights were 0.035, 0.028, and 0.027, respectively. CONCLUSION: This study has established a concrete, objective, and quantifiable competency assessment index system for standardized training of clinical resident physicians (including integrated postgraduates). This system provides a foundation for the quantitative evaluation of the competency of clinical resident physicians (including integrated postgraduates) undergoing standardized training.

Low Back Pain in Resident Doctors with Standardized Training in China: A Cross-Sectional Study.

Background: Low back pain (LBP) is a prevalent occupational disease with high morbidity among healthcare workers. Since the implementation of standardized residency training in China in 2015, the training intensity has significantly increased, which may lead to a higher incidence of LBP. However, epidemiological studies on LBP among resident doctors with standardized training remain scarce. Objective: To investigate the prevalence and associated factors of LBP among resident doctors with standardized training in a tertiary hospital in China. Methods: A cross-sectional study was conducted using self-administered questionnaires to collect information on demographics, lifestyle factors, work-related factors, and LBP from 345 resident doctors. Descriptive statistics were used to analyze the prevalence of LBP. Logistic regression analysis was performed to identify factors associated with LBP. Results: Among 345 participants, the 1-year prevalence of LBP was 75.9%. Multivariable analysis revealed that physical exercise, weekly working hours, and prolonged sitting were independent risk factors for LBP. Conclusion: The prevalence of LBP among resident doctors was high. Promoting physical exercise, controlling working hours, and improving sitting posture may help prevent LBP. The study was limited by its cross-sectional design and self-reported data. Future studies should use longitudinal designs, objective measures, and larger and more representative samples to further explore the epidemiology and etiology of LBP among resident doctors with standardized training.

Application of a flipped classroom teaching model based on micro-videos in the standardized training of dermatological residents in China.

Objective: To explore the effects of a micro-video-based flipped classroom teaching model on the standardized training of dermatological residents in China. Methods: A total of 78 residents who had received standardized training at the Department of Dermatology of the First Affiliated Hospital of Anhui Medical University were selected and randomly divided into an experimental group (39 residents) and a control group (39 residents). The experimental group received micro-video-based flipped classroom teaching, whereas the control group received traditional lecture-based classroom teaching. Scores relating to theoretical knowledge of dermatology, clinical practice skills, and the results of a questionnaire survey were used to evaluate the teaching effects. Results: The average score of the experimental group in the theoretical knowledge test (88.56 ± 5.80) was significantly higher than that of the control group (81.90 ± 7.45). Similarly, the average score of the experimental group in the clinical practice skills test (85.44 ± 5.97) was also significantly higher than that of the control group (78.46 ± 5.94). The results of the questionnaire survey showed that the experimental group exhibited significant improvements in learning interest, mastery of teaching content, communication skills, expression skills, clinical practice skills, autonomous learning, clinical thinking, clinical application, and team cooperation. Conclusion: Flipped classroom teaching based on micro-videos helped to improve the teaching effects of theoretical knowledge, clinical practice skills, and residents' comprehensive ability during dermatological residents' standardized training.

Implementation and Assessment of a Laparotomy-Assisted Three-Port Fetoscopic Spina Bifida Repair Program.

Open spina bifida (OSB) is a congenital, non-lethal malformation with multifactorial etiology. Fetal therapy can be offered under certain conditions to parents after accurate prenatal diagnostic and interdisciplinary counseling. Since the advent of prenatal OSB surgery, various modifications of the original surgical techniques have evolved, including laparotomy-assisted fetoscopic repair. After a two-year preparation time, the team at the University of Giessen and Marburg (UKGM) became the first center to provide a three-port, three-layer fetoscopic repair of OSB via a laparotomy-assisted approach in the German-speaking area. We point out that under the guidance of experienced centers and by intensive multidisciplinary preparation and training, a previously described and applied technique could be transferred to a different setting.

Inclusion of the workshop model in the standardized training of emergency medicine residents.

Background: Standardized training of resident physicians (STRP) includes clinical practice, professional required courses, and public required courses, among others. Of them, clinical practice is the most important as it allows residents to implement what they have learned in theoretical education to practice. Clinical practice includes different teaching methods, such as traditional lectures, bedside teaching, and workshops, and each method has its advantages and disadvantages in different situations of interest. Emergency medicine (EM) focuses on the diagnosis and treatment of urgent medical conditions and entails several emergency procedures. In this study, we aimed to compare the effects of workshop-based STRP and traditional STRP on emergency physicians. Methods: Overall, 125 residents who received STRP in EM between January and December 2021 were selected and randomly divided into two groups: the control group (n = 60; received traditional teaching) and the intervention group (n = 65; received workshop-based training). The theoretical performance, operative performance, and satisfaction of both groups were compared and analyzed. Results: Regarding theoretical assessment, the scores of airway management, cardiopulmonary resuscitation, and trauma management in the intervention group were 4.81 (t = 5.82, p < 0.001), 6.90 (t = 7.72, p < 0.001), and 5.25 (t = 6.14, p < 0.001), respectively. Regarding skill assessment, the scores for the same items in the intervention group were 4.43 (t = 5.30, p < 0.001), 4.55 (t = 5.61, p < 0.001), and 5.62 (t = 6.65, P < 0.001), respectively. Regarding satisfaction evaluation, the scores in the intervention group were 1.99 (t = 6.03, p < 0.001), 1.98 (t = 6.41, p < 0.001), and 1.96 (t = 6.14, p < 0.001), respectively. Overall, the scores were higher in the intervention group than in the control group. Conclusion: The workshop training model effectively improves the theoretical knowledge and practical skills of EM residents undergoing standardized training. The residents found the training and its outcomes satisfactory, ultimately improving their emergency response and first-responder skills.

Investigation of standardized training of radiation oncology residents for gynaecological tumours in China.

BACKGROUND: Radiotherapy standardized training (ST) has been conducted for 7 years in China. This investigation evaluated the difficulties of and need for ST of radiation oncology residents (RORs) for gynaecological tumours (GYN) in China. METHODS: An anonymous online survey was conducted on the "Questionnaire Star" platform. The questionnaire contained 30 questions, including the basic information of the students, their knowledge of radiotherapy theory, training on GYN, the difficulties and needs they faced, and possible solutions. RESULTS: A total of 469 valid questionnaires were collected, resulting in a valid response rate of 85.3%. During the ST, only 58-60% of RORs received training in GYN, with a median clinical rotation time of 2-3 months. Among the RORs surveyed, 50.1% knew the physical characteristics of brachytherapy (BRT), and 49.2% could choose the appropriate BRT for patients. At the end of ST, 75.3% were able to complete the target delineation in GYN independently, and 56% were able to complete the BRT operation independently. The scarcity of GYN patients, insufficient teaching awareness of superior doctors, and lack of interest are the main reasons why ST cannot meet the standard. CONCLUSION: In China, the ST of RORs in GYN should be strengthened, the teaching awareness of specialist trainers should be increased, and the curriculum should be optimized, especially the curriculum for specialist operation and a strict assessment system.

Application of a highly simulated and adaptable training system in the laparoscopic training course for surgical residents: Experience from a high-volume teaching hospital in China.

Objective: To explore the effectiveness, feasibility, and training effect of a highly simulated and adaptable laparoscopic training system in the advanced integrated two-stage laparoscopic simulation training course for surgical residents. Methods: This study prospectively took the surgical residents who received the advanced integrated two-stage laparoscopic simulation training course in our hospital from December 2019 to December 2021 as the research objects. In the stage one course, the trainees are randomly distributed into the dry simulation system group and Darwin laparoscopic training system group. The subjective assessment results of the trainees from the two groups are collected by questionnaires, and the simulation assessment results of the two groups are evaluated in a unified, objective, and standardized assessment form. The pre-course and post-course questionnaires were used to evaluate the feasibility and effectiveness of the Darwin system in the stage two course. Results: A total of 62 trainees completed the stage one and stage two courses. In the stage one course, the trainees were randomly distributed into the dry simulation trainer group (N = 19) and the Darwin group (N = 43). The results of the subjective assessment questionnaire showed that compared with the dry simulator group, the students in the Darwin group had higher subjective scores (P < 0.05). The objective assessment results for the 3 modules of "One Track Transfer", "One Tunnel Pass" and "High and Low Pillars" in the Darwin group were significantly better than those in the dry simulator group (P < 0.05). The trainees who received the stage two course completed the questionnaires before and after the course. The results showed that compared with pre-course evaluation, "basic theoretical knowledge of laparoscopy", "basic skills of laparoscopy", "laparoscopic suture technique" and "camera-holding technique" were significantly improved after training (P < 0.05). Conclusion: The highly simulated and adaptable laparoscopic training system is effective and feasible in the advanced integrated two-stage laparoscopic simulation training course for surgical residents.