A Study on the Current Status of Laparoscopic Skills Among Young Physicians: A Multicenter Cross-Sectional Study

A Study on the Current Status of Laparoscopic Skills Among Young Physicians: A Multicenter Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Study on the Current Status of Laparoscopic Skills Among Young Physicians: A Multicenter Cross-Sectional Study Xiang Jin, Xinye Lin, Yiyu Chen, Weihong Zhao, Yang Yang, Junbo Liang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8676149/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background As a cornerstone of minimally invasive surgery, laparoscopy poses considerable operational challenges for surgeons. This study assessed the current laparoscopic skill level among young physicians in Southern Zhejiang (China) and identified influencing factors. Methods A multicenter cross-sectional survey was conducted, recruiting young physicians from 24 hospitals to participate in a three-module laparoscopic skills competition. Pre-competition questionnaires were collected for correlation analysis. Results Among the 102 participants included in the skills assessment, 75 completed valid questionnaires. The mean total scores were as follows: circular cutting, 89.2 ± 17.5 (Completion: 64.1 ± 10.1; Technical: 18.1 ± 7.3; Bonus: 5.6 ± 6.8; 43.1% received no bonus); soybean transfer, 54.6 ± 22.0 (Completion: 53.1 ± 20.1; Bonus: 0.1 ± 1.5; 99% received no bonus); and fixed-point suturing, 83.2 ± 20.0 (Completion: 60.0 ± 14.7; Technical: 18.4 ± 3.6; Bonus: 3.3 ± 5.3; 63.7% received no bonus). Regression analysis indicated that prior laparoscopic training was associated with better performance in fixed-point suturing (P = 0.04). Cumulative training exceeding 30 hours correlated with higher scores in soybean transfer (P = 0.05) and fixed-point suturing (P = 0.04). Frequent simulation training significantly improved outcomes across all modules (P = 0.03, 0.05, 0.04). Participants who self-rated as “able to proficiently complete tasks within the allotted time” achieved notably higher scores, particularly in soybean transfer and suturing (P 0.05). Conclusion Young physicians in Southern Zhejiang demonstrate general competency in laparoscopic skills but perform less effectively in time-sensitive, high-precision tasks. Future training should emphasize systematic simulation and competitive practice to comprehensively enhance proficiency. Laparoscope Young Physicians Skills Training Simulation Training Competition Motivation Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Laparoscopic surgery, as the mainstream form of minimally invasive technology, has been widely applied in gynecology, general surgery, and cardiac surgery[ 1 ]. In recent years, research has consistently demonstrated the multiple advantages of laparoscopic surgery, particularly in terms of patient outcomes and healthcare efficiency, where it surpasses open surgery[ 2 – 4 ]. Laparoscopic surgery minimizes tissue damage and significantly alleviates postoperative pain for patients[ 5 ]. The minimally invasive nature of laparoscopic surgery significantly reduces surgical infections, decreases inflammatory responses, and minimizes incision size. This approach reduces scar formation, enhances cosmetic outcomes, and lowers the incidence of swelling and adhesions[ 6 ]. Despite this, laparoscopic technology still faces numerous challenges and bottlenecks, primarily due to its operational complexity and high technical barriers. Surgeons lack tactile feedback and depth perception during procedures, making precise instrument manipulation difficult, particularly in complex anatomical structures where tissue damage is prone to occur[ 7 , 8 ]. At the same time, beginners require extensive surgical experience to master the technique proficiently, during which complication rates and operating times are significantly higher than those of experienced practitioners. These limitations not only constrain the technology's universal applicability but also increase the consumption of medical resources[ 9 ]. The number of laparoscopic surgeries in China has shown a consistent upward trend, exceeding 10 million procedures annually[ 10 ]. Therefore, every qualified surgeon must acquire the theoretical knowledge related to Laparoscope and undergo systematic skills training. The current state of laparoscopic skills training for young physicians is not encouraging. In China, only 30.7% of young surgeons have received systematic laparoscopic training, with most training commencing during the attending physician stage. Coverage during the resident stage remains below 4%[ 10 ]. Swiss research indicates that existing surgical training programs fail to meet modern training requirements, exhibiting issues such as low utilization of simulation training resources, inadequate curriculum and assessment systems, and insufficient development of physicians' independent practice capabilities[ 11 ]. Research has also shown that training in cognitive abilities, flexibility, systematic techniques, spatial perception, and other areas can enhance laparoscopic skills[ 12 – 14 ]. Laparoscopic skills training plays a central role in enhancing physicians' fundamental competencies. By integrating theory with practice, it significantly improves surgical proficiency and shortens the learning curve[ 15 , 16 ]. Competitions can be used to evaluate the effectiveness of training. Furthermore, competitions can motivate young physicians to intensify their foundational laparoscopic training and practice before the event, thereby promoting skill enhancement through a goal-oriented approach[ 17 , 18 ]. This study examines participants in the laparoscopic skills assessment competition for young physicians in southern Zhejiang (China) province. By collecting competition results and pre-competition questionnaire data, it explores the overall proficiency level of laparoscopic skills among young physicians in southern Zhejiang province. Furthermore, it investigates the relationship between key factors, such as competition motivation, preparation status, and self-assessment of laparoscopic skill mastery and laparoscopic proficiency levels, along with their influencing factors. Methods Participants From February to March 2025, young physicians with basic laparoscopic skills were recruited from 24 hospitals in southern Zhejiang (China) province (Wenzhou and Taizhou). The research protocol was approved by the Ethics Committee of Taizhou Hospital, Zhejiang (China) Province (Approval No. K20251039) and conducted in accordance with the ethical guidelines of the World Medical Association (Declaration of Helsinki) and the CHERRIES Statement. Participants' personal information was fully anonymized. The screening process is illustrated in Fig. 1 . Eligibility requirements for Laparoscope competition participants: 1. Employed at an institution located in southern Zhejiang province; 2. Possess laparoscopic procedure experience; 3. Age not exceeding 40 years; 4. Complete competition information with no omissions. Requirements for Pre-Competition Questionnaire: 1. Participants in the laparoscopic skills competition; 2. Agreement to participate in the questionnaire; 3. Complete questionnaire information with no errors, omissions, or random entries. Part One: Laparoscopic Skills Competition This competition primarily consists of three modules: laparoscopic circular shearing, laparoscopic passing soybean and laparoscopic fixed-point suturing. The scoring criteria and schematic diagrams for the three modules are shown in Fig. 2 and Fig. 3 . For the specific scoring criteria of each module, please refer to Supplementary Materials Tables S1–3. Module 1: Laparoscopic Circular Shearing. This module primarily assesses participants' bilateral coordination and positioning skills. Each participant has 2 minutes with the paper fixed in place. Using laparoscopic dissection forceps and laparoscopic tissue scissors, participants must cut a circular pattern within the designated white circle (between two concentric black rings). After completion, judges will score based on the precision of the cut circle and its outline. Participants finishing early will receive bonus points for remaining time at a rate of 1 point per 2 seconds saved (e.g., 1 minute 45 seconds used, 15 seconds remaining = 8 bonus points). Module 2: Laparoscopic Passing Soybean. This module primarily assesses spatial orientation and bilateral hand coordination. During the competition, uniformly sized soybeans measuring 0.6 cm will be used. Please see Supplementary Figure S1 . Each participant has 2 minutes to complete the task, involving 25 beans and 20 vertical posts. Using forceps, participants must grasp a bean from a small dish, transfer it via separation forceps, and place it onto a vertical post without dropping it. Each successfully transferred bean earns 5 points. After completion, judges score based on beans remaining on the pillars. If all 20 beans are placed within 2 minutes, bonus points are awarded for remaining time at 1 point per second saved (e.g., 1 minute 45 seconds used + 15 seconds remaining = 15 bonus points). Module 3: Laparoscopic Fixed-Point Suturing. This module imposes higher demands on participants, primarily assessing positioning skills, depth perception judgment, instrument coordination, bilateral hand coordination, and hand-eye coordination. Each participant is allotted 5 minutes. Equipment provided per participant: 1 laparoscopic needle holder, 1 laparoscopic dissecting forceps, 1 laparoscopic scissor, and 1 suture with needle. The suturing module features 3 marked points: suture with forward knots at the 3 o'clock and 6 o'clock positions, and reverse knots at the 12 o'clock position. Each stitch requires a 2-1-1 knot (surgical knot-reverse knot-forward knot). Judges score based on the number and quality of stitches. Participants finishing early receive bonus points for remaining time: 1 point per 2 seconds saved (e.g., 4 minutes 45 seconds used with 15 seconds remaining = 8 bonus points). The competition results for each module are evaluated by three professional judges, all holding the title of Deputy Director or above and possessing specialized experience in laparoscopic surgery. The final score is determined by averaging the three judges' scores. All instruments and equipment used during the competition are uniformly arranged by the organizing unit. Should any issues affecting competition fairness arise due to equipment or instrument malfunctions during the event, the judging panel shall deliberate based on actual circumstances to decide whether a re-match is warranted. Competitors must strictly adhere to competition rules and comply with arrangements made by the judging committee. Should any competitor have objections to the scoring, they may file an appeal with the judging panel, which will render a final decision. Appeals must be submitted within 15 minutes after the conclusion of each module; appeals submitted after this timeframe will not be accepted. Competitors must not disclose any personal information, including names or hospital affiliations, during the competition. Part Two: Pre-Competition Questionnaire For this competition-based project, a multi-section online questionnaire was designed. The final questionnaire was developed by a panel of two experts in the relevant field to ensure comprehensive, effective, and scientifically sound content. Questions were designed using a Likert scale. The initial questionnaire underwent testing, followed by revisions based on feedback from the test group, ultimately resulting in the finalized version. All patients completing the questionnaire had selected consent to participate at the outset, guaranteeing that no participant was coerced into completing the survey. This approach ensured the accuracy and reliability of the questionnaire results. The questionnaire information primarily consists of four main sections: 1. Participant basic information (gender, age, education level, professional title, specialty, and years of experience); 2. Motivation for participation, including the following questions: to assess one's own laparoscopic skill level, challenge oneself, improve laparoscopic skills, fulfill teaching responsibilities, and enhance problem-solving abilities; 3. Preparation status, including the following questions: “Have you received laparoscopic training?”, “Total practice hours accumulated for this competition,” “Regularly conducted simulated laparoscopic surgery training during preparation,” “Timely identified and corrected deficiencies through simulation training,” and “Frequently reviewed exemplary laparoscopic surgery videos to learn techniques”; 4. Self-assessment of proficiency in competition tasks, including: “Proficiently performing circular shearing maneuvers with laparoscopic instruments,” “Complete circular shearing tasks within 2 minutes,” “Proficiently grasp soybeans with forceps and perform transfer tasks,” “Complete the transfer of 20 soybeans within 2 minutes,” “Maintain soybeans without dropping during transfer,” “Proficiently perform laparoscopic suturing at designated points,” “Complete 3 sutures on the suturing module within 5 minutes.” Data Analysis All statistical analyses in this study were performed using the R software (version 4.4.2). In the data description section, categorical data are presented as frequencies (percentages) [n (%)]. For continuous data, normality was assessed using the Shapiro-Wilk test. Data meeting normality assumptions are expressed as mean ± standard deviation (x ± s), while non-normally distributed data are presented as median (interquartile range) [M (Q1, Q3)]. Comparisons between groups were performed using appropriate methods based on data distribution characteristics and homogeneity of variance: independent samples t-tests were used for normally distributed data with homogeneity of variance; Wilcoxon signed-rank tests were used for comparisons between groups when data were not normally distributed or had heterogeneous variance. To further explore the relationship between competition performance and variables such as age and gender, linear regression analysis was employed. Results are presented as regression coefficients (β), standard errors (SE), t-values, and P-values. All hypothesis tests were two-tailed, with a significance level set at α = 0.05. Differences were considered statistically significant at P < 0.05. In the descriptive statistics of the questionnaire survey, responses of “Agree” and “Strongly Agree” on the Likert scale were grouped as “Agree,” while ‘Disagree’ and “Strongly Disagree” were grouped as “Disagree.” Results Laparoscopic Skills Competition Results This study included 108 participants, of whom 6 were excluded due to missing data, resulting in a final valid sample size of 102. All participants completed the competition assessment across three modules. Each module was scored by three independent judges using a scoring framework comprising objective project classification scoring, independent judge scoring and module aggregation. Participants' scores are shown in Fig. 4 . Module 1 involved circular shearing. The three judges demonstrated high consistency across all dimensions—completion, technical skills, bonus points, and module total score (ICC > 0.89 for each dimension and total score, P < 0.001)—with no significant judge bias. The mean score for completion was 64.1 ± 10.1 points, the mean technical score was 18.1 ± 7.3 points, and the mean bonus score was 5.6 ± 6.8 points, with 43.1% of participants receiving no bonus points. The mean module total score was 89.2 ± 17.5 points. Module 2 involved passing soybeans and comprised two components: completion criteria and bonus points. The three judges demonstrated perfect agreement across all scoring items (ICC = 1.00, P < 0.001). The average score for completion criteria was 53.1 ± 20.1 points, while the mean bonus points were 0.1 ± 1.5 points. 99.02% of participants received no bonus points, with the maximum achievable score being 15.0. The overall module mean score was 54.6 ± 22.0 points. Module 3 is the fixed-point suturing scoring sheet, which adopts a three-dimensional scoring structure comprising completion items, technical items, and bonus items. The three judges demonstrated high scoring consistency (ICC > 0.88, P < 0.001). The mean score for completion items was 60 ± 14.7 points, technical items averaged 18.4 ± 3.6 points, and bonus items averaged 3.3 ± 5.3 points. 63.73% of participants did not receive bonus points. The overall mean score for the module was 83.2 ± 20.0 points. Questionnaire Analysis The Impact of Demographic Characteristics on the Three Modules As shown in Fig. 1 , among the 102 participants included in the analysis, 77 completed the questionnaire survey. Two participants were excluded for failing to complete the third module competition, resulting in a final cohort of 75 participants. Table 1 reveals that regarding participant demographics, 68.0% (51/75) were male; 94.7% (71/75) were aged 30–40 years; educational backgrounds were predominantly master's degrees (54.7%, 41/75) and bachelor's degrees (44.0%, 33/75); Obstetrics and Gynecology was the most common specialty (29.3%, 22/75), followed by General Surgery (17.3%, 13/75) and Gastrointestinal Surgery (13.3%, 10/75); Attending Physician was the predominant professional title (60.0%, 45/75); Participants with ≥ 10 years and 6–9 years of work experience collectively accounted for 77.3% (58/75). Subsequently, univariate regression analysis was conducted on demographic characteristics and the three modules. Results indicated that variables including gender, educational background, professional title, and work experience showed no significant association with the total scores of the three modules (P > 0.05), suggesting that participants' basic characteristics did not influence their performance. See Tables 1 a and 1 b for details. Table 1 a. Demographic Characteristics (n = 75). Variables Categories n (%) Sex Male 51(68.0) Female 24(32.0) Age < 30 years old 4(5.3) 30–40 years old 71(94.7) Educational background Bachelor's Degree 33(44.0) Master's degree 41(54.7) Doctorate 1(1.3) Field of Specialization Obstetrics and Gynecology 22(29.3) General Surgery 13(17.3) Gastrointestinal Surgery 10(13.3) Urology 8(10.7) Hepatobiliary Surgery 8(10.7) Cardiac Surgery 3(4.0) Oncologic Surgery 2(2.7) Orthopedics 2(2.7) Others 7(9.3) Professional Title Resident Physician 16(21.3) Attending Physician 45(60.0) Associate Chief Physician 14(18.7) Years of Experience ≥ 10 years 31(41.3) 6–9 years 27(36.0) 1–5 years 16(21.3) < 1 years 1(1.3) Table 1 b. Regression Analysis of Demographic Characteristics and Module Scores (n = 75). Variables Categories Module 1 score Module 2 score Module 3 score Total Score Regression coefficient t-value p-value Regression coefficient t-value p-value Regression coefficient t-value p-value Regression coefficient t-value p-value Sex Female Vs. Male 0.07 0.02 0.99 -6.08 -1.11 0.27 -5.67 -1.14 0.26 -11.69 -1.00 0.32 Age Continuous variable -0.60 -0.97 0.33 -1.52 -2.01 0.05 -0.81 -1.15 0.25 -2.92 -1.80 0.08 Educational background Master's Degree vs. Bachelor's Degree 0.32 0.08 0.94 5.28 1.02 0.31 4.82 1.01 0.32 10.41 0.93 0.35 Doctorate vs. Bachelor's Degree 7.67 0.42 0.67 -21.97 -0.98 0.33 -4.45 -0.22 0.83 -18.75 -0.39 0.70 Field of Specialization Obstetrics and Gynecology vs. General Surgery 2.81 0.46 0.65 4.14 0.52 0.61 -3.04 -0.42 0.68 3.91 0.23 0.82 Hepatobiliary Surgery vs. General Surgery -4.00 -0.51 0.61 10.34 1.00 0.32 -6.00 -0.64 0.53 0.34 0.02 0.99 Gastrointestinal Surgery vs. General Surgery 2.40 0.32 0.75 2.91 0.29 0.77 1.38 0.15 0.88 6.68 0.32 0.75 Cardiac Surgery vs. General Surgery 15.99 1.44 0.16 18.46 1.25 0.21 10.12 0.76 0.45 44.58 1.45 0.15 Emergency Department vs. General Surgery 13.77 0.77 0.45 -1.54 -0.07 0.95 22.32 1.03 0.31 34.55 0.70 0.49 Oncologic Surgery vs. General Surgery 22.93 1.74 0.09 -1.54 -0.09 0.93 15.59 0.98 0.33 36.99 1.02 0.31 Urology vs. General Surgery -1.42 -0.18 0.86 2.84 0.28 0.78 -3.81 -0.41 0.69 -2.39 -0.11 0.91 Orthopedic Surgery vs. General Surgery -28.82 -2.19 0.03 -16.54 -0.95 0.35 -15.34 -0.97 0.34 -60.70 -1.67 0.10 Other Specialties vs. General Surgery -6.06 -0.34 0.74 -21.54 -0.90 0.37 -8.34 -0.39 0.70 -35.94 -0.72 0.47 Colon and Rectal Surgery vs. General Surgery 3.93 0.30 0.77 3.46 0.20 0.84 8.39 0.53 0.60 15.79 0.43 0.67 Hernia Surgery vs. General Surgery 14.10 0.78 0.44 28.46 1.19 0.24 23.72 1.10 0.28 66.28 1.33 0.19 Pediatric Surgery vs. General Surgery -9.40 -0.52 0.60 -16.54 -0.69 0.49 -15.01 -0.69 0.49 -40.95 -0.82 0.41 Breast and Thyroid Surgery vs. General Surgery 17.77 0.99 0.33 -16.54 -0.69 0.49 11.86 0.55 0.59 13.09 0.26 0.78 Professional Title Attending Physician vs. Resident Physician -3.80 -0.73 0.47 -10.22 -1.55 0.13 -2.11 -0.35 0.73 -15.12 -1.15 0.26 Associate Chief Physician vs. Resident Physician 4.45 0.68 0.50 -8.41 -1.02 0.31 4.21 0.56 0.58 0.25 0.01 0.99 Years of Experience 6–9 years vs. 1–5 years 1.63 0.29 0.77 1.70 0.25 0.81 6.11 0.98 0.33 9.44 0.65 0.52 ≥ 10 years vs. 1–5 years -4.52 -0.83 0.41 -7.83 -1.16 0.25 -4.75 -0.78 0.44 -17.10 -1.20 0.23 The Impact of Motivation on the Performance of Three Modules As shown in Table 2 , participants demonstrated diverse yet clear motivations for competing. Among the reasons cited, 92.0% aimed to challenge themselves, followed by testing their laparoscopic skill level (89.3%) and improving their laparoscopic skill level (89.3%). Additionally, 90.6% of participants expressed interest in laparoscopic techniques. Only 30.7% participated due to hospital requirements or to fulfill teaching obligations. Although individual variations existed in total motivation scores, the overall trend indicated a positive attitude centered on skill enhancement, interest-driven participation, and self-actualization. Competition motivations were quantified, with “strongly agree” scored as 5 points, and so on. The lowest motivation score was 30, the highest was 55, and the average was 44.03 points. Regression results indicated no correlation between competition motivation and scores across the three modules (P > 0.05), as shown in Table 2 . Table 2 Distribution of Questionnaire Items on Participation Motivation and Their Regression Analysis with Module Scores (n = 75). Variables Strongly disagree n(%) Disagree n(%) Generally n(%) Agree n(%) Strongly agree n(%) Questionnaire Items on Motivation for Participation Assess one's own laparoscopic skills 0(0.0) 1(1.3) 7(9.3) 34(45.3) 33(44.0) Challenge yourself 0(0.0) 1(1.3) 5(6.7) 39(52.0) 30(40.0) Enhance laparoscopic skills 0(0.0) 0(0.0) 8(10.7) 34(45.3) 33(44.0) To achieve personal goals 2(2.7) 0(0.0) 14(18.7) 38(50.7) 21(28.0) Win an award 4(5.3) 6(8.0) 22(29.3) 29(38.7) 14(18.7) Build self-confidence 1(1.3) 1(1.3) 14(18.7) 38(50.7) 21(28.0) Interest in laparoscopic technology 0(0.0) 0(0.0) 7(9.3) 40(53.3) 28(37.3) Time spent with peers 0(0.0) 0(0.0) 11(14.7) 41(54.7) 23(30.7) Enjoy the competition process 0(0.0) 1(1.3) 14(18.7) 38(50.7) 22(29.3) Hospital requirements, fulfill teaching responsibilities 12(16.0) 16(21.3) 24(32.0) 17(22.7) 6(8.0) Enhance problem-solving skills 1(1.3) 0(0.0) 15(20.0) 40(53.3) 19(25.3) Regression Analysis of Competition Motivation Regression coefficient t-value p-value Module 1 score 0.03 0.10 0.92 Module 2 score 0.47 1.08 0.28 Module 3 score 0.39 1.00 0.32 The Impact of Preparation on Performance in the Three Modules Among the participants' preparation status, 40 participants (53.3%) had received laparoscopic training. 32 participants (42.7%) frequently engaged in laparoscopic simulation training, with 15 accumulating over 20 hours of training. with 6 participants exceeding 30 hours. 52 participants (69.4%) believed simulation training enabled them to promptly identify and improve their shortcomings. 29 participants preferred watching high quality laparoscopic surgery videos to learn techniques. See Table 3 a for details. Table 3 a. Questionnaire Distribution of Competition Preparation Status. Variables Categories n (%) Have you received laparoscopic training? Yes 40(53.3) No 35(46.7) Do you frequently conduct simulation training? Strongly disagree 7(9.3) Disagree 8(10.7) Generally 28(37.3) Strongly agree 26(34.7) Agree 6(8.0) Cumulative training duration < 5 h 22(29.3) 5–9 h 15(20.0) 10–19 h 23(30.7) 20–29 h 9(12.0) ≥ 30 h 6(8.0) Improve shortcomings through simulation training Strongly disagree 2(2.7) Disagree 1(1.3) Generally 20(26.7) Strongly agree 44(58.7) Agree 8(10.7) Regularly watch high-quality laparoscopic surgery videos and learn the techniques demonstrated Strongly disagree 5(6.7) Disagree 3(4.0) Generally 38(50.7) Strongly agree 24(32.0) Agree 5(6.7) Table 3 b. Regression Analysis of Competition Preparation Status and Module Performance. Variables Categories Module 1 score Module 2 score Module 3 score Regression coefficient t-value p-value Regression coefficient t-value p-value Regression coefficient t-value p-value Have you received laparoscopic training? Yes vs. No -0.33 -0.08 0.94 7.29 1.44 0.15 9.73 2.15 0.04 Do you frequently conduct simulation training? Strongly disagree Vs. Disagree 0.67 0.08 0.94 -5.89 -0.55 0.58 4.11 0.40 0.69 General Vs. Disagree 8.12 1.18 0.24 -12.50 -1.52 0.13 0.16 0.02 0.98 Agree vs. Disagree 2.80 0.40 0.69 -2.02 -0.24 0.81 -0.15 -0.02 0.98 Strongly Agree Vs. Disagree 20.15 2.18 0.03 22.08 1.99 0.05 21.74 2.04 0.04 Cumulative training duration < 5 h Vs. 10–19 h -5.66 -1.11 0.27 -5.71 -0.89 0.38 -3.43 -0.58 0.56 5–9 h Vs. 10–19 h 3.27 0.58 0.57 0.99 0.14 0.89 -0.43 -0.06 0.95 20–29 h Vs. 10–19 h -6.37 -0.95 0.35 1.21 0.14 0.89 -0.20 -0.03 0.98 ≥ 30 h Vs. 10–19 h 13.27 1.70 0.09 19.82 2.00 0.05 18.72 2.07 0.04 Improve shortcomings through simulation training Strongly disagree Vs. Disagree 24.00 1.13 0.26 -17.50 -0.71 0.48 17.00 0.74 0.46 General Vs. Disagree 28.17 1.59 0.12 -21.00 -1.02 0.31 17.03 0.88 0.38 Agree vs. Disagree 31.16 1.78 0.08 -10.00 -0.49 0.63 8.42 0.44 0.66 Strongly Agree Vs. Disagree 38.56 2.10 0.04 14.38 0.67 0.50 33.72 1.69 0.10 Regularly watch high-quality laparoscopic surgery videos and learn the techniques demonstrated Strongly disagree Vs. Disagree -5.35 -0.42 0.68 -5.00 -0.35 0.73 -9.34 -0.67 0.51 General Vs. Disagree 2.73 0.26 0.80 -10.53 -0.89 0.38 -14.72 -1.29 0.20 Agree vs. Disagree -1.60 -0.15 0.88 -6.04 -0.50 0.62 -10.45 -0.89 0.37 Strongly Agree Vs. Disagree 12.25 0.96 0.34 33.00 2.29 0.03 14.76 1.06 0.29 Regression analysis indicates that positive preparation significantly impacts performance across all three competition modules. Participants who frequently engaged in simulation training demonstrated significantly higher scores in Module 1 (P = 0.03), Module 2 (P = 0.05), and Module 3 (P = 0.04). Participants with training durations exceeding 30 hours achieved higher scores in Module 2 (P = 0.05) and Module 3 (P = 0.04). Participants who addressed deficiencies identified through simulation training demonstrated improved performance in Module 1 (P = 0.04). Consequently, pre-competition simulation training contributes to enhanced competition performance, as detailed in Table 3 b. The Impact of Self-Assessment of Laparoscopic Skill Competition Item Mastery on Performance in Three Modules Participants' self-assessment of mastery in laparoscopic skill competition items showed an overall positive trend (Table 4 a). In the circular shearing operation item, 33 participants (44%) believed they could proficiently complete the cutting maneuver, but only 25 participants (33.3%) felt they could accomplish it within 2 minutes. For the proficient passing soybean task, 33 participants (44%) believed they could skillfully grasp and transfer soybeans using forceps, yet only 17 (22.7%) felt capable of completing the task of transferring soybeans across 20 pillars within 2 minutes. while 16 (21.3%) believed they could simultaneously prevent beans from dropping. Thirty-eight participants (50.6%) considered themselves proficient in performing fixed-point suturing on the laparoscopic suturing module, and 33 participants (44%) believed they could complete the three-stitch suturing task on the module within 5 minutes. Results indicate participants believed they could complete the competition, but some harbored self-doubt when finishing ahead of schedule. Table 4 a. Self-Assessment of Mastery in Laparoscopic Skills Competition Items. Variables Strongly disagree n(%) Disagree n(%) Generally n(%) Agree n(%) Strongly agree n(%) Proficient in performing circular cutting maneuvers with laparoscopic instruments 3(4.0) 9(12.0) 30(40.0) 30(40.0) 3(4.0) Complete the circular cutting task within 2 minutes 3(4.0) 11(14.7) 36(48.0) 22(29.3) 3(4.0) Proficiently use the gripper to pick up soybeans and transfer them 1(1.3) 7(9.3) 34(45.3) 28(37.3) 5(6.7) Complete the soybean transfer task for 20 columns within 2 minutes 9(12.0) 18(24.0) 31(41.3) 12(16.0) 5(6.7) Ensure soybeans do not fall during transfer 8(10.7) 13(17.3) 38(50.7) 12(16.0) 4(5.3) Proficient in performing laparoscopic suturing at specific points 3(4.0) 5(6.7) 29(38.7) 34(45.3) 4(5.3) Complete the 3-stitch suturing task on the suturing module within 5 minutes 4(5.3) 8(10.7) 30(40.0) 29(38.7) 4(5.3) Table 4 b. Regression Analysis of Competition Preparation Status, Mastery of Competition Events, and Module Scores. Module 1 score Module 2 score Module 3 score Variables Categories Regression coefficient t-value p-value Regression coefficient t-value p-value Regression coefficient t-value p-value Proficient in performing circular cutting maneuvers with laparoscopic instruments Strongly disagree Vs. Disagree 0.87 0.07 0.94 -16.67 -1.23 0.22 1.15 0.09 0.93 General Vs. Disagree 5.69 0.85 0.40 -2.17 -0.28 0.78 8.58 1.16 0.25 Agree vs. Disagree 2.22 0.33 0.74 7.00 0.91 0.37 13.36 1.80 0.08 Strongly Agree Vs. Disagree 19.37 1.66 0.10 41.67 3.08 0.00 32.73 2.52 0.01 Complete the circular cutting task within 2 minutes Strongly disagree Vs. Disagree 0.61 0.05 0.96 -11.36 -0.84 0.40 4.90 0.39 0.70 General Vs. Disagree 5.48 0.91 0.37 8.91 1.25 0.22 14.63 2.21 0.03 Agree vs. Disagree 1.14 0.18 0.86 9.09 1.19 0.24 18.37 2.58 0.01 Strongly Agree Vs. Disagree 18.22 1.59 0.12 43.64 3.23 0.00 31.86 2.54 0.01 Proficiently use the gripper to pick up soybeans and transfer them Strongly disagree Vs. Disagree 1.81 0.10 0.92 -32.14 -1.46 0.15 3.92 0.19 0.85 General Vs. Disagree 9.68 1.34 0.19 -1.70 -0.20 0.84 14.49 1.78 0.08 Agree vs. Disagree 8.75 1.19 0.24 4.29 0.49 0.63 14.75 1.78 0.08 Strongly Agree Vs. Disagree 20.24 1.98 0.05 30.86 2.55 0.01 29.94 2.60 0.01 Complete the soybean transfer task for 20 columns within 2 minutes Strongly disagree Vs. Disagree 6.42 0.90 0.37 -7.50 -0.96 0.34 3.42 0.44 0.66 General Vs. Disagree 3.50 0.68 0.50 1.08 0.19 0.85 5.85 1.04 0.30 Agree vs. Disagree 8.78 1.35 0.18 16.53 2.31 0.02 15.07 2.14 0.04 Strongly Agree Vs. Disagree 15.21 1.72 0.09 40.28 4.16 0.00 30.80 3.22 0.00 Ensure soybeans do not fall during transfer Strongly disagree Vs. Disagree 17.39 2.29 0.03 -2.64 -0.28 0.78 10.51 1.18 0.24 General Vs. Disagree 14.54 2.67 0.01 9.23 1.36 0.18 12.50 1.96 0.05 Agree vs. Disagree 7.32 1.08 0.28 19.23 2.27 0.03 13.36 1.68 0.10 Strongly Agree Vs. Disagree 8.68 0.90 0.37 25.48 2.11 0.04 21.96 1.94 0.06 Proficient in performing laparoscopic suturing at specific points Strongly disagree Vs. Disagree 9.11 0.73 0.47 -21.00 -1.39 0.17 7.45 0.52 0.60 General Vs. Disagree 15.74 1.91 0.06 -3.07 -0.31 0.76 16.22 1.72 0.09 Agree vs. Disagree 9.42 1.16 0.25 -2.47 -0.25 0.80 17.60 1.88 0.06 Strongly Agree Vs. Disagree 28.04 2.46 0.02 32.75 2.36 0.02 35.23 2.69 0.01 Complete the 3-stitch suturing task on the suturing module within 5 minutes Strongly disagree Vs. Disagree 2.40 0.22 0.82 -6.88 -0.54 0.59 2.77 0.23 0.82 General Vs. Disagree 6.95 1.00 0.32 6.04 0.73 0.47 13.08 1.68 0.10 Agree vs. Disagree 4.45 0.64 0.52 5.84 0.71 0.48 12.18 1.56 0.12 Strongly Agree Vs. Disagree 21.60 2.03 0.05 40.63 3.20 0.00 30.52 2.54 0.01 Further regression analysis results indicate (Table 4 b) that self-assessment significantly influences competition performance. Participants who self-assessed as proficient in performing three sutures within five minutes demonstrated significantly improved scores across all three modules (P < 0.05). Participants who self-assessed as proficient in grasping and transferring soybeans within 2 minutes demonstrated significantly higher scores in Modules 2 and 3 (P < 0.01). Notably, participants who believed they could proficiently perform circular shearing within 2 minutes actually showed significantly lower scores in Modules 2 and 3 (P < 0.05). Participants who self-assessed positively for Module 1 did not perform well in that module. This discrepancy may be related to sample size or may indicate overconfidence in Module 1 performance. Discussion The core objective of medical education is to cultivate highly competent physicians capable of clinical practice, with laparoscopic surgical skills serving as a core competency for surgeons and practitioners in related disciplines. This study comprehensively assessed the laparoscopic skill proficiency of young physicians in southern Zhejiang province by analyzing their competition results and pre-competition questionnaire data from laparoscopic skills contest. It further explored the impact of multiple factors on competition performance, including participants' motivations, preparation status, and self-assessment of mastery in the contest's skill categories. Research findings indicate that participants demonstrated overall strong performance in the three fundamental modules: circular shearing, passing soybean, and fixed-point suturing. Competence in circular shearing and fixed-point suturing was notably high, reflecting a high level of proficiency. However, overall scores were significantly lower in the passing soybean task, highlighting young physicians' limited ability to perform spatial manipulation and placement under laparoscopic conditions within a short timeframe. Further regression analysis indicated that participants' active competition preparation, such as frequent simulation training, attendance at simulation workshops, and addressing weaknesses through practice significantly influenced their scores. Additionally, participants who self-assessed their proficiency in the three modules as good achieved higher scores, particularly in Modules 2 and 3. This self-evaluation reflected their understanding of their capabilities, contributing to improved performance during the competition. In summary, young physicians in southern Zhejiang province demonstrate generally strong laparoscopic skills, with performance primarily influenced by proactive competition preparation and self-assessment of skill mastery. Therefore, enhanced laparoscopic simulation training and incentive mechanisms like competitions should be implemented to effectively motivate physicians toward self-directed learning and skill enhancement, thereby comprehensively elevating their laparoscopic proficiency. Multi-module assessment reveals participants' laparoscopic skill proficiency The participants in this study were predominantly male, holding master's or bachelor's degrees, specializing in obstetrics and gynecology, serving as attending physicians, and possessing ≥ 6 years of professional experience. This cohort constitutes the core workforce performing clinical laparoscopic surgeries, whose skill proficiency directly impacts the overall improvement of regional laparoscopic diagnostic and therapeutic quality. Therefore, this study selected three modules (Circular Shearing, Passing Soybean, and Fixed-Point Suturing)for competition assessment. This choice not only simulates the most frequently used precision operations in clinical practice (such as instrument control, spatial manipulation, and suturing for hemostasis) but also aims to provide empirical evidence for identifying skill gaps and optimizing training programs for this primary workforce through targeted evaluation. Overall performance across modules revealed higher scores for Module 1 (circular shearing) and Module 3 (fixed-point suturing). In contrast, Module 2 (passing soybean) demonstrated relatively lower scores. This indicates that young physicians in southern Zhejiang province exhibit greater proficiency in cutting and suturing techniques. The lower performance in Module 2 may stem from the heightened demands for dexterity and precision required to transfer 20 soybeans within 2 minutes. This also reflects that most physicians exhibit deficiencies in spatial orientation and instrument passing during laparoscopic procedures, with corresponding specialized training appearing inadequate. This issue may become particularly pronounced in clinical scenarios requiring precise placement during laparoscopic operations, such as critical steps like vessel clamping with hemostats. Precise placement techniques can effectively reduce the risk of surgery-related complications[ 19 ]. Therefore, future training must strengthen systematic simulation exercises, particularly high-intensity, targeted drills. The majority of participants' motivations for participating tend to be positive and constructive. In terms of motivation for participating, over 87% of participants aimed to test their skills, challenge themselves, and improve their proficiency. Only 30.7% participated due to hospital requirements or to fulfill teaching assignments. This indicates that participants were primarily driven by a desire to enhance their own skills and a passion for laparoscopic techniques[ 20 ].It is noteworthy that although there was no statistically significant difference in the overall motivation score across the three modules, previous studies have found that stimulating trainees' enthusiasm for learning and training can more effectively enhance their laparoscopic skills during training[ 21 , 22 ].Therefore, the impact of a positive attitude on improving laparoscopic skills should not be overlooked during training[ 23 ].This also indirectly reflects potential irregularities in China's laparoscopic technology training system and assessment standards. The fact that most participants aspire to enhance and test their technical proficiency through competitions precisely reveals their insufficient self-awareness regarding their own skill levels. This phenomenon is further illustrated in the following self-assessment analysis. Preparation for competitions and self-assessment contribute to enhancing laparoscopic skills. Research findings confirm that targeted pre-competition simulation training is a key factor in improving performance outcomes. Participants who underwent laparoscopic simulation training, dedicated extended simulation practice time, and identified and corrected their own shortcomings during training achieved higher scores in the final competition. Systematic simulation training not only enhances precision and stability in instrument handling but also strengthens participants' ability to adapt to on-the-spot challenges[ 24 ].Research data indicates that participants who undergo prolonged and regular simulation training exhibit significantly lower operational error rates compared to those with shorter training durations. This reduction is directly attributable to the muscle memory and neural reflex efficiency developed through sustained practice[ 25 , 26 ].It is worth noting that training effectiveness depends not only on the accumulation of training hours. Proactive reflection and addressing shortcomings are even more crucial, such as through video review analysis, discussions with mentors or colleagues, and other methods[ 27 , 28 ].Similarly, in this study, participants who could identify and correct problems promptly achieved higher scores in the competition. Consequently, those who perceived improvements in their skills tended to feel more confident and motivated to continue training, creating a virtuous cycle[ 29 , 30 ]. Competitors who are proficient in their event may have accumulated extensive experience through daily training and practice, possessing a clear understanding of their own capabilities. This positive self-awareness also helps them perform at higher level during competitions[ 31 ]. Long-term systematic training and regular assessments help participants recognize shortcomings in their laparoscopic techniques. The majority of participants demonstrated a positive attitude toward the competition, reflecting their desire to evaluate their skills and identify areas for improvement. Similarly, this study found that participants with higher self-assessments of mastery in laparoscopic skill competition items performed more effectively during the competition. In laparoscopic skill competitions, participants with high self-assessment levels typically possess a clear understanding of their strengths and weaknesses. This self-awareness enables them to target and strengthen their weaker areas during preparation, allowing them to allocate their energy more effectively and confidently during the competition itself[ 32 ].At the same time, positive self-perception can also positively influence performance through psychological suggestion. Individuals with high self-assessment typically possess stronger self-efficacy beliefs, which can alleviate competition anxiety and enhance focus and on-the-spot adaptability[ 33 ]. As this study found, participants with high self-assessments in laparoscopic skill competitions demonstrated significantly superior operational fluency, task completion quality, and time management compared to those with lower self-assessments. This also reflects a positive feedback loop between accumulated experience, self-awareness, and competition performance. Implications for Future Laparoscopic Training Based on this study's empirical analysis of laparoscopic skill performance and influencing factors among young physicians in southern Zhejiang province, valuable insights are provided for future laparoscopic skill training. First, while most participants possessed foundational laparoscopic skills, deficiencies in operational proficiency were evident. This situation may stem from the absence of standardized training protocols for basic laparoscopic techniques in China, particularly regarding systematic development of core competencies such as bilateral coordination, instrument manipulation, and hand-eye coordination. Consequently, many physicians accumulate experience through a “learn-by-doing” approach during clinical practice. However, thorough foundational training is essential for transitioning to clinical laparoscopic skills. Inadequate basic proficiency impedes mastery of subsequent clinical techniques. Future training programs must therefore establish a tiered, progressive curriculum with clear requirements for practice duration and frequency, reinforcing fundamental laparoscopic skills. Solid foundational skills are the prerequisite for clinicians to achieve rapid and precise maneuvers, with their importance becoming particularly evident in emergency scenarios[ 34 ]. For instance, in critical situations such as vascular rupture or tissue hemorrhage, precise hemostasis within a short timeframe directly impacts surgical success rates and patient rescue efficiency, thereby significantly reducing adverse surgical complications and improving patient outcomes. To address this characteristic, the competition specifically introduced time-limited bonus points to evaluate precise operations within the allotted time. This mechanism effectively exposed the shortcoming that most young physicians struggle to perform intricate laparoscopic maneuvers within tight timeframes. This assessment approach should be adopted in future competitions. Furthermore, skill competitions foster a positive competitive environment that “promotes learning through competition and practice through competition.” This sparks and sustains young physicians' motivation to learn, encouraging them to deeply integrate daily training with competitive practice, thereby systematically elevating their laparoscopic proficiency. After mastering fundamental laparoscopic techniques, specialized skill competitions can be introduced. Tailoring training and competition content to distinct surgical specialties, such as VR simulations of laparoscopic cholecystectomy or appendectomy, significantly enhances training relevance and clinical applicability, ensuring skill development aligns closely with specialty requirements. Limitations and Future Directions This study has certain limitations. First, the sample was drawn exclusively from participants in this competition, potentially introducing selection bias and failing to fully represent the skill levels and competitive motivations of all endoscopists. Second, the three projects in this study focused on developing basic endoscopic manipulation skills while neglecting more complex clinical scenarios and actual surgical procedures. Therefore, future research should emphasize enhancing decision-making capabilities during real-time surgeries. Third, this study is a descriptive study and did not include a control group. Finally, the Likert scale may fail to capture genuine differences in competition motivation due to its limited sensitivity, susceptibility to response bias, and restricted construct coverage, potentially yielding a false impression of statistical non-differentiation. Future research should expand the sample size to include physicians from diverse regions and departments. Additionally, incorporating assessment items more closely aligned with clinical practice, such as competitions and training in simulated surgical scenarios that evaluate comprehensive skills, enables a more comprehensive evaluation of laparoscopic surgeons’ skill levels and training effectiveness. Conclusion This study found that young physicians in southern Zhejiang province demonstrate overall proficiency in laparoscopic skills. However, they remain relatively weak in performing technically demanding procedures that require completing operations ahead of schedule, with precision and fluidity within time constraints. Young physicians who actively prepare for competitions and hold high self-assessments of their laparoscopic skills significantly influence competition outcomes. Future laparoscopic training should consider enhancing systematic simulation training and fostering a learning-through-competition environment via skill contests to comprehensively elevate laparoscopic proficiency. Declarations Ethics approval and consent to participate This retrospective study was approved by the Institutional Review Board (Ethics Committee) of Taizhou Hospital in Zhejiang Province (Approval No. K20251039). The requirement for written informed consent was waived by the Ethics Committee due to the use of anonymized and de-identified patient data. All data were analyzed in an aggregated and anonymous manner to protect patient privacy. This study was conducted in accordance with the ethical standards of the World Medical Association (Declaration of Helsinki) and the CHERRIES Statement. Consent for publication All authors have read and agreed to the published version of the manuscript. Competing interests Xiang Jin, Xinye Lin, Yiyu Chen, Weihong Zhao, Yang Yang, Junbo Liang, Weilin Li, have no conflict of interest or financial ties to disclose. Funding A Research Project on the Application of Standardized Patients in Practical Teaching (T-2025006) Author Contribution Weilin Li and Junbo Liang onceptualized and designed the study. Weihong Zhao and Yang Yang participated in the study design. Yiyu Chen collected some data. Xiang Jin and Xinye Lin collected data and was responsible for statistical analysis and manuscript writing. Acknowledgement We extend our gratitude to all authors for their significant contributions to this paper. Data Availability The data and materials supporting the conclusions of this article can be obtained by contacting the corresponding author. References Ye SP, Zhu WQ, Huang ZX, Liu DN, Wen XQ, Li TY. Role of minimally invasive techniques in gastrointestinal surgery: Current status and future perspectives. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8676149","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":605177696,"identity":"92b153a9-5b85-4ca0-bc5f-edddf099886a","order_by":0,"name":"Xiang Jin","email":"","orcid":"","institution":"Zhejiang Taizhou Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xiang","middleName":"","lastName":"Jin","suffix":""},{"id":605177697,"identity":"16634ff3-8a8c-4b30-88b6-82436299cd9c","order_by":1,"name":"Xinye Lin","email":"","orcid":"","institution":"Zhejiang Taizhou Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xinye","middleName":"","lastName":"Lin","suffix":""},{"id":605177698,"identity":"838b19de-0d53-4b04-a320-0c5bf793079d","order_by":2,"name":"Yiyu Chen","email":"","orcid":"","institution":"Zhejiang Taizhou Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yiyu","middleName":"","lastName":"Chen","suffix":""},{"id":605177699,"identity":"6ec9920b-3346-42a5-b525-779a29189bec","order_by":3,"name":"Weihong Zhao","email":"","orcid":"","institution":"Zhejiang Taizhou Hospital","correspondingAuthor":false,"prefix":"","firstName":"Weihong","middleName":"","lastName":"Zhao","suffix":""},{"id":605177700,"identity":"a81bc773-5bea-4b11-86bb-bf8933318558","order_by":4,"name":"Yang Yang","email":"","orcid":"","institution":"Zhejiang Taizhou Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yang","middleName":"","lastName":"Yang","suffix":""},{"id":605177701,"identity":"8f038db3-06fb-4d89-82f8-ba59a25d26ec","order_by":5,"name":"Junbo Liang","email":"","orcid":"","institution":"Zhejiang Taizhou Hospital","correspondingAuthor":false,"prefix":"","firstName":"Junbo","middleName":"","lastName":"Liang","suffix":""},{"id":605177702,"identity":"26cee615-69a9-40f8-8f66-bafd6fc721da","order_by":6,"name":"Weilin Li","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2ElEQVRIiWNgGAWjYBACPmYGxgMfKmzk+KECjA2EtLAxMzAcnHEmzViygWgtQHyYs+1Q4oYDRGth5zE4zMB2wNj4eO/hDx9zbGQb2A8f3YDfYUAtBTx35MzOnEswnLktzbiBJy3tBn4tvBsOz5B4Zmx2I8cgmXfb4cQGCR4zwlqAFiVunv/G4PDfbf+J1ZJwOHGDBI9hM+O2A8Ro4f9wcMaBNGOJMznGjL3bko3bCPmFn/9Y4oOP/4BR2X7G+MPPbXay/eyHj+HVgsVe0pSPglEwCkbBKMAGABsaT2axHpuwAAAAAElFTkSuQmCC","orcid":"","institution":"Zhejiang Taizhou Hospital","correspondingAuthor":true,"prefix":"","firstName":"Weilin","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2026-01-23 07:24:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8676149/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8676149/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104593904,"identity":"c198c621-e272-4819-9dd4-ee45f8a21bb8","added_by":"auto","created_at":"2026-03-13 17:46:40","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":96737,"visible":true,"origin":"","legend":"\u003cp\u003eScreening Flowchart.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8676149/v1/f0cfc48b8a94317d6447a64c.jpg"},{"id":104593907,"identity":"fbce70ce-b1e4-4474-984d-2cb3d71f4f1d","added_by":"auto","created_at":"2026-03-13 17:46:40","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":176669,"visible":true,"origin":"","legend":"\u003cp\u003eScoring Criteria and Schematic Diagram for the Three Modules.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8676149/v1/74ae0adb9b3afee3d5e3d1a8.jpg"},{"id":104593908,"identity":"28544494-c028-4a24-beed-bf772aa6e59e","added_by":"auto","created_at":"2026-03-13 17:46:40","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":165514,"visible":true,"origin":"","legend":"\u003cp\u003eCompetition venue.\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8676149/v1/dafede6b31bf9bc48364fca4.jpg"},{"id":104593905,"identity":"001c47be-4ad8-4548-8b2b-d1be02198c0b","added_by":"auto","created_at":"2026-03-13 17:46:40","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":139115,"visible":true,"origin":"","legend":"\u003cp\u003eScore distributions and judge evaluations for the three modules.\u003c/p\u003e\n\u003cp\u003e(A-B) Score distributions from three judges and participants' sub-item scores for Module 1; (C-D) Score distributions from three judges and participants' sub-item scores for Module 2; (E-F) Score distributions from three judges and participants' sub-item scores for Module 3.\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8676149/v1/365ddb4e48f3c7cfd8f7087f.jpg"},{"id":104782014,"identity":"ca6f8ca4-ce3a-4ce1-9d2e-4b44d47713b0","added_by":"auto","created_at":"2026-03-17 07:56:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2404427,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8676149/v1/168cde1b-2b02-46dc-b4f1-b042106c33b5.pdf"},{"id":104593906,"identity":"2fa575f2-9e32-4546-a4fd-ac285b08eeee","added_by":"auto","created_at":"2026-03-13 17:46:40","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":468112,"visible":true,"origin":"","legend":"","description":"","filename":"4.Supplementarymaterials.docx","url":"https://assets-eu.researchsquare.com/files/rs-8676149/v1/30861859cbf204479fc3d806.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Study on the Current Status of Laparoscopic Skills Among Young Physicians: A Multicenter Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eLaparoscopic surgery, as the mainstream form of minimally invasive technology, has been widely applied in gynecology, general surgery, and cardiac surgery[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In recent years, research has consistently demonstrated the multiple advantages of laparoscopic surgery, particularly in terms of patient outcomes and healthcare efficiency, where it surpasses open surgery[\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Laparoscopic surgery minimizes tissue damage and significantly alleviates postoperative pain for patients[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The minimally invasive nature of laparoscopic surgery significantly reduces surgical infections, decreases inflammatory responses, and minimizes incision size. This approach reduces scar formation, enhances cosmetic outcomes, and lowers the incidence of swelling and adhesions[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Despite this, laparoscopic technology still faces numerous challenges and bottlenecks, primarily due to its operational complexity and high technical barriers. Surgeons lack tactile feedback and depth perception during procedures, making precise instrument manipulation difficult, particularly in complex anatomical structures where tissue damage is prone to occur[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. At the same time, beginners require extensive surgical experience to master the technique proficiently, during which complication rates and operating times are significantly higher than those of experienced practitioners. These limitations not only constrain the technology's universal applicability but also increase the consumption of medical resources[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The number of laparoscopic surgeries in China has shown a consistent upward trend, exceeding 10\u0026nbsp;million procedures annually[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Therefore, every qualified surgeon must acquire the theoretical knowledge related to Laparoscope and undergo systematic skills training.\u003c/p\u003e \u003cp\u003eThe current state of laparoscopic skills training for young physicians is not encouraging. In China, only 30.7% of young surgeons have received systematic laparoscopic training, with most training commencing during the attending physician stage. Coverage during the resident stage remains below 4%[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Swiss research indicates that existing surgical training programs fail to meet modern training requirements, exhibiting issues such as low utilization of simulation training resources, inadequate curriculum and assessment systems, and insufficient development of physicians' independent practice capabilities[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Research has also shown that training in cognitive abilities, flexibility, systematic techniques, spatial perception, and other areas can enhance laparoscopic skills[\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Laparoscopic skills training plays a central role in enhancing physicians' fundamental competencies. By integrating theory with practice, it significantly improves surgical proficiency and shortens the learning curve[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Competitions can be used to evaluate the effectiveness of training. Furthermore, competitions can motivate young physicians to intensify their foundational laparoscopic training and practice before the event, thereby promoting skill enhancement through a goal-oriented approach[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e This study examines participants in the laparoscopic skills assessment competition for young physicians in southern Zhejiang (China) province. By collecting competition results and pre-competition questionnaire data, it explores the overall proficiency level of laparoscopic skills among young physicians in southern Zhejiang province. Furthermore, it investigates the relationship between key factors, such as competition motivation, preparation status, and self-assessment of laparoscopic skill mastery and laparoscopic proficiency levels, along with their influencing factors.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eFrom February to March 2025, young physicians with basic laparoscopic skills were recruited from 24 hospitals in southern Zhejiang (China) province (Wenzhou and Taizhou). The research protocol was approved by the Ethics Committee of Taizhou Hospital, Zhejiang (China) Province (Approval No. K20251039) and conducted in accordance with the ethical guidelines of the World Medical Association (Declaration of Helsinki) and the CHERRIES Statement. Participants' personal information was fully anonymized. The screening process is illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eEligibility requirements for Laparoscope competition participants: 1. Employed at an institution located in southern Zhejiang province; 2. Possess laparoscopic procedure experience; 3. Age not exceeding 40 years; 4. Complete competition information with no omissions.\u003c/p\u003e \u003cp\u003eRequirements for Pre-Competition Questionnaire: 1. Participants in the laparoscopic skills competition; 2. Agreement to participate in the questionnaire; 3. Complete questionnaire information with no errors, omissions, or random entries.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePart One: Laparoscopic Skills Competition\u003c/h3\u003e\n\u003cp\u003eThis competition primarily consists of three modules: laparoscopic circular shearing, laparoscopic passing soybean and laparoscopic fixed-point suturing. The scoring criteria and schematic diagrams for the three modules are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. For the specific scoring criteria of each module, please refer to Supplementary Materials Tables S1\u0026ndash;3.\u003c/p\u003e \u003cp\u003eModule 1: Laparoscopic Circular Shearing. This module primarily assesses participants' bilateral coordination and positioning skills. Each participant has 2 minutes with the paper fixed in place. Using laparoscopic dissection forceps and laparoscopic tissue scissors, participants must cut a circular pattern within the designated white circle (between two concentric black rings). After completion, judges will score based on the precision of the cut circle and its outline. Participants finishing early will receive bonus points for remaining time at a rate of 1 point per 2 seconds saved (e.g., 1 minute 45 seconds used, 15 seconds remaining\u0026thinsp;=\u0026thinsp;8 bonus points).\u003c/p\u003e \u003cp\u003eModule 2: Laparoscopic Passing Soybean. This module primarily assesses spatial orientation and bilateral hand coordination. During the competition, uniformly sized soybeans measuring 0.6 cm will be used. Please see Supplementary Figure \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e. Each participant has 2 minutes to complete the task, involving 25 beans and 20 vertical posts. Using forceps, participants must grasp a bean from a small dish, transfer it via separation forceps, and place it onto a vertical post without dropping it. Each successfully transferred bean earns 5 points. After completion, judges score based on beans remaining on the pillars. If all 20 beans are placed within 2 minutes, bonus points are awarded for remaining time at 1 point per second saved (e.g., 1 minute 45 seconds used\u0026thinsp;+\u0026thinsp;15 seconds remaining\u0026thinsp;=\u0026thinsp;15 bonus points).\u003c/p\u003e \u003cp\u003eModule 3: Laparoscopic Fixed-Point Suturing. This module imposes higher demands on participants, primarily assessing positioning skills, depth perception judgment, instrument coordination, bilateral hand coordination, and hand-eye coordination. Each participant is allotted 5 minutes. Equipment provided per participant: 1 laparoscopic needle holder, 1 laparoscopic dissecting forceps, 1 laparoscopic scissor, and 1 suture with needle. The suturing module features 3 marked points: suture with forward knots at the 3 o'clock and 6 o'clock positions, and reverse knots at the 12 o'clock position. Each stitch requires a 2-1-1 knot (surgical knot-reverse knot-forward knot). Judges score based on the number and quality of stitches. Participants finishing early receive bonus points for remaining time: 1 point per 2 seconds saved (e.g., 4 minutes 45 seconds used with 15 seconds remaining\u0026thinsp;=\u0026thinsp;8 bonus points).\u003c/p\u003e \u003cp\u003eThe competition results for each module are evaluated by three professional judges, all holding the title of Deputy Director or above and possessing specialized experience in laparoscopic surgery. The final score is determined by averaging the three judges' scores. All instruments and equipment used during the competition are uniformly arranged by the organizing unit. Should any issues affecting competition fairness arise due to equipment or instrument malfunctions during the event, the judging panel shall deliberate based on actual circumstances to decide whether a re-match is warranted. Competitors must strictly adhere to competition rules and comply with arrangements made by the judging committee. Should any competitor have objections to the scoring, they may file an appeal with the judging panel, which will render a final decision. Appeals must be submitted within 15 minutes after the conclusion of each module; appeals submitted after this timeframe will not be accepted. Competitors must not disclose any personal information, including names or hospital affiliations, during the competition.\u003c/p\u003e\n\u003ch3\u003ePart Two: Pre-Competition Questionnaire\u003c/h3\u003e\n\u003cp\u003eFor this competition-based project, a multi-section online questionnaire was designed. The final questionnaire was developed by a panel of two experts in the relevant field to ensure comprehensive, effective, and scientifically sound content. Questions were designed using a Likert scale. The initial questionnaire underwent testing, followed by revisions based on feedback from the test group, ultimately resulting in the finalized version. All patients completing the questionnaire had selected consent to participate at the outset, guaranteeing that no participant was coerced into completing the survey. This approach ensured the accuracy and reliability of the questionnaire results.\u003c/p\u003e \u003cp\u003eThe questionnaire information primarily consists of four main sections: 1. Participant basic information (gender, age, education level, professional title, specialty, and years of experience); 2. Motivation for participation, including the following questions: to assess one's own laparoscopic skill level, challenge oneself, improve laparoscopic skills, fulfill teaching responsibilities, and enhance problem-solving abilities; 3. Preparation status, including the following questions: \u0026ldquo;Have you received laparoscopic training?\u0026rdquo;, \u0026ldquo;Total practice hours accumulated for this competition,\u0026rdquo; \u0026ldquo;Regularly conducted simulated laparoscopic surgery training during preparation,\u0026rdquo; \u0026ldquo;Timely identified and corrected deficiencies through simulation training,\u0026rdquo; and \u0026ldquo;Frequently reviewed exemplary laparoscopic surgery videos to learn techniques\u0026rdquo;; 4. Self-assessment of proficiency in competition tasks, including: \u0026ldquo;Proficiently performing circular shearing maneuvers with laparoscopic instruments,\u0026rdquo; \u0026ldquo;Complete circular shearing tasks within 2 minutes,\u0026rdquo; \u0026ldquo;Proficiently grasp soybeans with forceps and perform transfer tasks,\u0026rdquo; \u0026ldquo;Complete the transfer of 20 soybeans within 2 minutes,\u0026rdquo; \u0026ldquo;Maintain soybeans without dropping during transfer,\u0026rdquo; \u0026ldquo;Proficiently perform laparoscopic suturing at designated points,\u0026rdquo; \u0026ldquo;Complete 3 sutures on the suturing module within 5 minutes.\u0026rdquo;\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eAll statistical analyses in this study were performed using the R software (version 4.4.2). In the data description section, categorical data are presented as frequencies (percentages) [n (%)]. For continuous data, normality was assessed using the Shapiro-Wilk test. Data meeting normality assumptions are expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x\u0026thinsp;\u0026plusmn;\u0026thinsp;s), while non-normally distributed data are presented as median (interquartile range) [M (Q1, Q3)]. Comparisons between groups were performed using appropriate methods based on data distribution characteristics and homogeneity of variance: independent samples t-tests were used for normally distributed data with homogeneity of variance; Wilcoxon signed-rank tests were used for comparisons between groups when data were not normally distributed or had heterogeneous variance. To further explore the relationship between competition performance and variables such as age and gender, linear regression analysis was employed. Results are presented as regression coefficients (β), standard errors (SE), t-values, and P-values. All hypothesis tests were two-tailed, with a significance level set at α\u0026thinsp;=\u0026thinsp;0.05. Differences were considered statistically significant at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05. In the descriptive statistics of the questionnaire survey, responses of \u0026ldquo;Agree\u0026rdquo; and \u0026ldquo;Strongly Agree\u0026rdquo; on the Likert scale were grouped as \u0026ldquo;Agree,\u0026rdquo; while \u0026lsquo;Disagree\u0026rsquo; and \u0026ldquo;Strongly Disagree\u0026rdquo; were grouped as \u0026ldquo;Disagree.\u0026rdquo;\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eLaparoscopic Skills Competition Results\u003c/h2\u003e \u003cp\u003eThis study included 108 participants, of whom 6 were excluded due to missing data, resulting in a final valid sample size of 102. All participants completed the competition assessment across three modules. Each module was scored by three independent judges using a scoring framework comprising objective project classification scoring, independent judge scoring and module aggregation. Participants' scores are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eModule 1 involved circular shearing. The three judges demonstrated high consistency across all dimensions\u0026mdash;completion, technical skills, bonus points, and module total score (ICC\u0026thinsp;\u0026gt;\u0026thinsp;0.89 for each dimension and total score, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u0026mdash;with no significant judge bias. The mean score for completion was 64.1\u0026thinsp;\u0026plusmn;\u0026thinsp;10.1 points, the mean technical score was 18.1\u0026thinsp;\u0026plusmn;\u0026thinsp;7.3 points, and the mean bonus score was 5.6\u0026thinsp;\u0026plusmn;\u0026thinsp;6.8 points, with 43.1% of participants receiving no bonus points. The mean module total score was 89.2\u0026thinsp;\u0026plusmn;\u0026thinsp;17.5 points.\u003c/p\u003e \u003cp\u003eModule 2 involved passing soybeans and comprised two components: completion criteria and bonus points. The three judges demonstrated perfect agreement across all scoring items (ICC\u0026thinsp;=\u0026thinsp;1.00, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The average score for completion criteria was 53.1\u0026thinsp;\u0026plusmn;\u0026thinsp;20.1 points, while the mean bonus points were 0.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 points. 99.02% of participants received no bonus points, with the maximum achievable score being 15.0. The overall module mean score was 54.6\u0026thinsp;\u0026plusmn;\u0026thinsp;22.0 points.\u003c/p\u003e \u003cp\u003eModule 3 is the fixed-point suturing scoring sheet, which adopts a three-dimensional scoring structure comprising completion items, technical items, and bonus items. The three judges demonstrated high scoring consistency (ICC\u0026thinsp;\u0026gt;\u0026thinsp;0.88, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The mean score for completion items was 60\u0026thinsp;\u0026plusmn;\u0026thinsp;14.7 points, technical items averaged 18.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.6 points, and bonus items averaged 3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.3 points. 63.73% of participants did not receive bonus points. The overall mean score for the module was 83.2\u0026thinsp;\u0026plusmn;\u0026thinsp;20.0 points.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eQuestionnaire Analysis\u003c/h3\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eThe Impact of Demographic Characteristics on the Three Modules\u003c/h2\u003e \u003cp\u003eAs shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, among the 102 participants included in the analysis, 77 completed the questionnaire survey. Two participants were excluded for failing to complete the third module competition, resulting in a final cohort of 75 participants. Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e reveals that regarding participant demographics, 68.0% (51/75) were male; 94.7% (71/75) were aged 30\u0026ndash;40 years; educational backgrounds were predominantly master's degrees (54.7%, 41/75) and bachelor's degrees (44.0%, 33/75); Obstetrics and Gynecology was the most common specialty (29.3%, 22/75), followed by General Surgery (17.3%, 13/75) and Gastrointestinal Surgery (13.3%, 10/75); Attending Physician was the predominant professional title (60.0%, 45/75); Participants with \u0026ge;\u0026thinsp;10 years and 6\u0026ndash;9 years of work experience collectively accounted for 77.3% (58/75). Subsequently, univariate regression analysis was conducted on demographic characteristics and the three modules. Results indicated that variables including gender, educational background, professional title, and work experience showed no significant association with the total scores of the three modules (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), suggesting that participants' basic characteristics did not influence their performance. See Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003ea and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003eb for details.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ea. Demographic Characteristics (n\u0026thinsp;=\u0026thinsp;75).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51(68.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24(32.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;40 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71(94.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducational background\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33(44.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster's degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41(54.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctorate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003eField of Specialization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eObstetrics and Gynecology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22(29.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13(17.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGastrointestinal Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10(13.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8(10.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHepatobiliary Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8(10.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCardiac Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(4.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOncologic Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2(2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOrthopedics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2(2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7(9.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eProfessional Title\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResident Physician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16(21.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttending Physician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45(60.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAssociate Chief Physician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14(18.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eYears of Experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31(41.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;9 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27(36.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16(21.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eb. Regression Analysis of Demographic Characteristics and Module Scores (n\u0026thinsp;=\u0026thinsp;75).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eModule 1 score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eModule 2 score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003eModule 3 score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c14\" namest=\"c12\"\u003e \u003cp\u003eTotal Score\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale Vs. Male\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-6.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-5.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-11.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContinuous variable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-2.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-2.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-1.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEducational\u003c/p\u003e \u003cp\u003ebackground\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster's Degree vs. Bachelor's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e10.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctorate vs. Bachelor's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-21.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-4.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-18.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"12\" rowspan=\"13\"\u003e \u003cp\u003eField of\u003c/p\u003e \u003cp\u003eSpecialization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eObstetrics and Gynecology vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-3.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e3.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHepatobiliary Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-4.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-6.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGastrointestinal Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e6.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCardiac Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e18.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e10.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e44.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e1.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmergency Department vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e22.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e34.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOncologic Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e15.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e36.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrology vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-3.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-2.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOrthopedic Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-28.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-2.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-16.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-15.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-60.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-1.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther Specialties vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-6.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-21.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-8.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-35.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eColon and Rectal Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e15.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHernia Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e28.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e23.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e66.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e1.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePediatric Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-9.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-16.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-15.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-40.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBreast and Thyroid Surgery vs. General Surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-16.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e11.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e13.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProfessional Title\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttending Physician vs. Resident Physician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-3.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-10.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-2.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-15.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAssociate Chief Physician vs. Resident Physician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-8.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eYears of Experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;9 years vs. 1\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e6.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e9.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10 years vs. 1\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-4.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-7.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-4.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-17.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e-1.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eThe Impact of Motivation on the Performance of Three Modules\u003c/h2\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e, participants demonstrated diverse yet clear motivations for competing. Among the reasons cited, 92.0% aimed to challenge themselves, followed by testing their laparoscopic skill level (89.3%) and improving their laparoscopic skill level (89.3%). Additionally, 90.6% of participants expressed interest in laparoscopic techniques. Only 30.7% participated due to hospital requirements or to fulfill teaching obligations. Although individual variations existed in total motivation scores, the overall trend indicated a positive attitude centered on skill enhancement, interest-driven participation, and self-actualization. Competition motivations were quantified, with \u0026ldquo;strongly agree\u0026rdquo; scored as 5 points, and so on. The lowest motivation score was 30, the highest was 55, and the average was 44.03 points. Regression results indicated no correlation between competition motivation and scores across the three modules (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of Questionnaire Items on Participation Motivation and Their Regression Analysis with Module Scores (n\u0026thinsp;=\u0026thinsp;75).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGenerally\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestionnaire Items on Motivation for Participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAssess one's own laparoscopic skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e34(45.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e33(44.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChallenge yourself\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39(52.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e30(40.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnhance laparoscopic skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8(10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e34(45.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e33(44.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTo achieve personal goals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14(18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38(50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e21(28.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWin an award\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22(29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29(38.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14(18.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBuild self-confidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14(18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38(50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e21(28.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInterest in laparoscopic technology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e40(53.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e28(37.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime spent with peers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11(14.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e41(54.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e23(30.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnjoy the competition process\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14(18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38(50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e22(29.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital requirements, fulfill teaching responsibilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12(16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24(32.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17(22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e6(8.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnhance problem-solving skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15(20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e40(53.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e19(25.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegression Analysis of Competition Motivation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModule 1 score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModule 2 score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModule 3 score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eThe Impact of Preparation on Performance in the Three Modules\u003c/h2\u003e \u003cp\u003eAmong the participants' preparation status, 40 participants (53.3%) had received laparoscopic training. 32 participants (42.7%) frequently engaged in laparoscopic simulation training, with 15 accumulating over 20 hours of training. with 6 participants exceeding 30 hours. 52 participants (69.4%) believed simulation training enabled them to promptly identify and improve their shortcomings. 29 participants preferred watching high quality laparoscopic surgery videos to learn techniques. See Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e3\u003c/span\u003ea for details.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ea. Questionnaire Distribution of Competition Preparation Status.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHave you received laparoscopic training?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40(53.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35(46.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eDo you frequently conduct simulation training?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7(9.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8(10.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGenerally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28(37.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26(34.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6(8.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eCumulative training duration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22(29.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;9 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15(20.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u0026ndash;19 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23(30.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;29 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9(12.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6(8.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eImprove shortcomings through simulation training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2(2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGenerally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20(26.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44(58.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8(10.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eRegularly watch high-quality laparoscopic surgery videos and learn the techniques demonstrated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5(6.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(4.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGenerally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38(50.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24(32.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5(6.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eb. Regression Analysis of Competition Preparation Status and Module Performance.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eModule 1 score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eModule 2 score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003eModule 3 score\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHave you received laparoscopic training?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes vs. No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e9.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e2.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eDo you frequently conduct simulation training?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-5.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-12.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-2.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e22.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e21.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e2.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eCumulative training duration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5 h Vs. 10\u0026ndash;19 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-5.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-5.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-3.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;9 h Vs. 10\u0026ndash;19 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;29 h Vs. 10\u0026ndash;19 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-6.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30 h Vs. 10\u0026ndash;19 h\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e19.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e18.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eImprove shortcomings through simulation training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-17.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-21.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e17.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-10.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e33.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eRegularly watch high-quality laparoscopic surgery videos and learn the techniques demonstrated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-5.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-5.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-9.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-10.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-14.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-1.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-6.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-10.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e-0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e33.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e14.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegression analysis indicates that positive preparation significantly impacts performance across all three competition modules. Participants who frequently engaged in simulation training demonstrated significantly higher scores in Module 1 (P\u0026thinsp;=\u0026thinsp;0.03), Module 2 (P\u0026thinsp;=\u0026thinsp;0.05), and Module 3 (P\u0026thinsp;=\u0026thinsp;0.04). Participants with training durations exceeding 30 hours achieved higher scores in Module 2 (P\u0026thinsp;=\u0026thinsp;0.05) and Module 3 (P\u0026thinsp;=\u0026thinsp;0.04). Participants who addressed deficiencies identified through simulation training demonstrated improved performance in Module 1 (P\u0026thinsp;=\u0026thinsp;0.04). Consequently, pre-competition simulation training contributes to enhanced competition performance, as detailed in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e3\u003c/span\u003eb.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eThe Impact of Self-Assessment of Laparoscopic Skill Competition Item Mastery on Performance in Three Modules\u003c/h2\u003e \u003cp\u003eParticipants' self-assessment of mastery in laparoscopic skill competition items showed an overall positive trend (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e4\u003c/span\u003ea). In the circular shearing operation item, 33 participants (44%) believed they could proficiently complete the cutting maneuver, but only 25 participants (33.3%) felt they could accomplish it within 2 minutes. For the proficient passing soybean task, 33 participants (44%) believed they could skillfully grasp and transfer soybeans using forceps, yet only 17 (22.7%) felt capable of completing the task of transferring soybeans across 20 pillars within 2 minutes. while 16 (21.3%) believed they could simultaneously prevent beans from dropping. Thirty-eight participants (50.6%) considered themselves proficient in performing fixed-point suturing on the laparoscopic suturing module, and 33 participants (44%) believed they could complete the three-stitch suturing task on the module within 5 minutes. Results indicate participants believed they could complete the competition, but some harbored self-doubt when finishing ahead of schedule.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ea. Self-Assessment of Mastery in Laparoscopic Skills Competition Items.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGenerally\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003cp\u003en(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProficient in performing circular cutting maneuvers with laparoscopic instruments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9(12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30(40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30(40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3(4.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete the circular cutting task within 2 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11(14.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36(48.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22(29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3(4.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProficiently use the gripper to pick up soybeans and transfer them\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7(9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34(45.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28(37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5(6.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete the soybean transfer task for 20 columns within 2 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9(12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18(24.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31(41.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12(16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5(6.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnsure soybeans do not fall during transfer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8(10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13(17.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38(50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12(16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProficient in performing laparoscopic suturing at specific points\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5(6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29(38.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e34(45.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplete the 3-stitch suturing task on the suturing module within 5 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4(5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8(10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30(40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29(38.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eb. Regression Analysis of Competition Preparation Status, Mastery of Competition Events, and Module Scores.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eModule 1 score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eModule 2 score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003eModule 3 score\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eRegression\u003c/p\u003e \u003cp\u003ecoefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eProficient in performing circular cutting maneuvers with laparoscopic instruments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-16.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-2.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e13.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e41.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e32.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eComplete the circular cutting task within 2 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-11.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e14.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e18.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e43.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e31.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eProficiently use the gripper to pick up soybeans and transfer them\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-32.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e14.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e14.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e29.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eComplete the soybean transfer task for 20 columns within 2 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-7.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e15.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e30.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEnsure soybeans do not fall during transfer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e10.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e12.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e13.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e21.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eProficient in performing laparoscopic suturing at specific points\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-21.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e7.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-3.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e16.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-2.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e17.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e32.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e35.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eComplete the 3-stitch suturing task on the suturing module within 5 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly disagree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-6.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e13.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e12.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree Vs. Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e30.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFurther regression analysis results indicate (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e4\u003c/span\u003eb) that self-assessment significantly influences competition performance. Participants who self-assessed as proficient in performing three sutures within five minutes demonstrated significantly improved scores across all three modules (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Participants who self-assessed as proficient in grasping and transferring soybeans within 2 minutes demonstrated significantly higher scores in Modules 2 and 3 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Notably, participants who believed they could proficiently perform circular shearing within 2 minutes actually showed significantly lower scores in Modules 2 and 3 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Participants who self-assessed positively for Module 1 did not perform well in that module. This discrepancy may be related to sample size or may indicate overconfidence in Module 1 performance.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe core objective of medical education is to cultivate highly competent physicians capable of clinical practice, with laparoscopic surgical skills serving as a core competency for surgeons and practitioners in related disciplines. This study comprehensively assessed the laparoscopic skill proficiency of young physicians in southern Zhejiang province by analyzing their competition results and pre-competition questionnaire data from laparoscopic skills contest. It further explored the impact of multiple factors on competition performance, including participants' motivations, preparation status, and self-assessment of mastery in the contest's skill categories.\u003c/p\u003e \u003cp\u003eResearch findings indicate that participants demonstrated overall strong performance in the three fundamental modules: circular shearing, passing soybean, and fixed-point suturing. Competence in circular shearing and fixed-point suturing was notably high, reflecting a high level of proficiency. However, overall scores were significantly lower in the passing soybean task, highlighting young physicians' limited ability to perform spatial manipulation and placement under laparoscopic conditions within a short timeframe. Further regression analysis indicated that participants' active competition preparation, such as frequent simulation training, attendance at simulation workshops, and addressing weaknesses through practice significantly influenced their scores. Additionally, participants who self-assessed their proficiency in the three modules as good achieved higher scores, particularly in Modules 2 and 3. This self-evaluation reflected their understanding of their capabilities, contributing to improved performance during the competition. In summary, young physicians in southern Zhejiang province demonstrate generally strong laparoscopic skills, with performance primarily influenced by proactive competition preparation and self-assessment of skill mastery. Therefore, enhanced laparoscopic simulation training and incentive mechanisms like competitions should be implemented to effectively motivate physicians toward self-directed learning and skill enhancement, thereby comprehensively elevating their laparoscopic proficiency.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eMulti-module assessment reveals participants' laparoscopic skill proficiency\u003c/h2\u003e \u003cp\u003eThe participants in this study were predominantly male, holding master's or bachelor's degrees, specializing in obstetrics and gynecology, serving as attending physicians, and possessing\u0026thinsp;\u0026ge;\u0026thinsp;6 years of professional experience. This cohort constitutes the core workforce performing clinical laparoscopic surgeries, whose skill proficiency directly impacts the overall improvement of regional laparoscopic diagnostic and therapeutic quality. Therefore, this study selected three modules (Circular Shearing, Passing Soybean, and Fixed-Point Suturing)for competition assessment. This choice not only simulates the most frequently used precision operations in clinical practice (such as instrument control, spatial manipulation, and suturing for hemostasis) but also aims to provide empirical evidence for identifying skill gaps and optimizing training programs for this primary workforce through targeted evaluation. Overall performance across modules revealed higher scores for Module 1 (circular shearing) and Module 3 (fixed-point suturing).\u003c/p\u003e \u003cp\u003eIn contrast, Module 2 (passing soybean) demonstrated relatively lower scores. This indicates that young physicians in southern Zhejiang province exhibit greater proficiency in cutting and suturing techniques. The lower performance in Module 2 may stem from the heightened demands for dexterity and precision required to transfer 20 soybeans within 2 minutes. This also reflects that most physicians exhibit deficiencies in spatial orientation and instrument passing during laparoscopic procedures, with corresponding specialized training appearing inadequate. This issue may become particularly pronounced in clinical scenarios requiring precise placement during laparoscopic operations, such as critical steps like vessel clamping with hemostats. Precise placement techniques can effectively reduce the risk of surgery-related complications[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Therefore, future training must strengthen systematic simulation exercises, particularly high-intensity, targeted drills.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe majority of participants' motivations for participating tend to be positive and constructive.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIn terms of motivation for participating, over 87% of participants aimed to test their skills, challenge themselves, and improve their proficiency. Only 30.7% participated due to hospital requirements or to fulfill teaching assignments. This indicates that participants were primarily driven by a desire to enhance their own skills and a passion for laparoscopic techniques[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].It is noteworthy that although there was no statistically significant difference in the overall motivation score across the three modules, previous studies have found that stimulating trainees' enthusiasm for learning and training can more effectively enhance their laparoscopic skills during training[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].Therefore, the impact of a positive attitude on improving laparoscopic skills should not be overlooked during training[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].This also indirectly reflects potential irregularities in China's laparoscopic technology training system and assessment standards. The fact that most participants aspire to enhance and test their technical proficiency through competitions precisely reveals their insufficient self-awareness regarding their own skill levels. This phenomenon is further illustrated in the following self-assessment analysis.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePreparation for competitions and self-assessment contribute to enhancing laparoscopic skills.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eResearch findings confirm that targeted pre-competition simulation training is a key factor in improving performance outcomes. Participants who underwent laparoscopic simulation training, dedicated extended simulation practice time, and identified and corrected their own shortcomings during training achieved higher scores in the final competition. Systematic simulation training not only enhances precision and stability in instrument handling but also strengthens participants' ability to adapt to on-the-spot challenges[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].Research data indicates that participants who undergo prolonged and regular simulation training exhibit significantly lower operational error rates compared to those with shorter training durations. This reduction is directly attributable to the muscle memory and neural reflex efficiency developed through sustained practice[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].It is worth noting that training effectiveness depends not only on the accumulation of training hours. Proactive reflection and addressing shortcomings are even more crucial, such as through video review analysis, discussions with mentors or colleagues, and other methods[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].Similarly, in this study, participants who could identify and correct problems promptly achieved higher scores in the competition. Consequently, those who perceived improvements in their skills tended to feel more confident and motivated to continue training, creating a virtuous cycle[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCompetitors who are proficient in their event may have accumulated extensive experience through daily training and practice, possessing a clear understanding of their own capabilities. This positive self-awareness also helps them perform at higher level during competitions[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Long-term systematic training and regular assessments help participants recognize shortcomings in their laparoscopic techniques. The majority of participants demonstrated a positive attitude toward the competition, reflecting their desire to evaluate their skills and identify areas for improvement. Similarly, this study found that participants with higher self-assessments of mastery in laparoscopic skill competition items performed more effectively during the competition. In laparoscopic skill competitions, participants with high self-assessment levels typically possess a clear understanding of their strengths and weaknesses. This self-awareness enables them to target and strengthen their weaker areas during preparation, allowing them to allocate their energy more effectively and confidently during the competition itself[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].At the same time, positive self-perception can also positively influence performance through psychological suggestion. Individuals with high self-assessment typically possess stronger self-efficacy beliefs, which can alleviate competition anxiety and enhance focus and on-the-spot adaptability[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. As this study found, participants with high self-assessments in laparoscopic skill competitions demonstrated significantly superior operational fluency, task completion quality, and time management compared to those with lower self-assessments. This also reflects a positive feedback loop between accumulated experience, self-awareness, and competition performance.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eImplications for Future Laparoscopic Training\u003c/h2\u003e \u003cp\u003eBased on this study's empirical analysis of laparoscopic skill performance and influencing factors among young physicians in southern Zhejiang province, valuable insights are provided for future laparoscopic skill training. First, while most participants possessed foundational laparoscopic skills, deficiencies in operational proficiency were evident. This situation may stem from the absence of standardized training protocols for basic laparoscopic techniques in China, particularly regarding systematic development of core competencies such as bilateral coordination, instrument manipulation, and hand-eye coordination. Consequently, many physicians accumulate experience through a \u0026ldquo;learn-by-doing\u0026rdquo; approach during clinical practice.\u003c/p\u003e \u003cp\u003eHowever, thorough foundational training is essential for transitioning to clinical laparoscopic skills. Inadequate basic proficiency impedes mastery of subsequent clinical techniques. Future training programs must therefore establish a tiered, progressive curriculum with clear requirements for practice duration and frequency, reinforcing fundamental laparoscopic skills. Solid foundational skills are the prerequisite for clinicians to achieve rapid and precise maneuvers, with their importance becoming particularly evident in emergency scenarios[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. For instance, in critical situations such as vascular rupture or tissue hemorrhage, precise hemostasis within a short timeframe directly impacts surgical success rates and patient rescue efficiency, thereby significantly reducing adverse surgical complications and improving patient outcomes. To address this characteristic, the competition specifically introduced time-limited bonus points to evaluate precise operations within the allotted time. This mechanism effectively exposed the shortcoming that most young physicians struggle to perform intricate laparoscopic maneuvers within tight timeframes. This assessment approach should be adopted in future competitions.\u003c/p\u003e \u003cp\u003eFurthermore, skill competitions foster a positive competitive environment that \u0026ldquo;promotes learning through competition and practice through competition.\u0026rdquo; This sparks and sustains young physicians' motivation to learn, encouraging them to deeply integrate daily training with competitive practice, thereby systematically elevating their laparoscopic proficiency. After mastering fundamental laparoscopic techniques, specialized skill competitions can be introduced. Tailoring training and competition content to distinct surgical specialties, such as VR simulations of laparoscopic cholecystectomy or appendectomy, significantly enhances training relevance and clinical applicability, ensuring skill development aligns closely with specialty requirements.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e \u003cp\u003eThis study has certain limitations. First, the sample was drawn exclusively from participants in this competition, potentially introducing selection bias and failing to fully represent the skill levels and competitive motivations of all endoscopists. Second, the three projects in this study focused on developing basic endoscopic manipulation skills while neglecting more complex clinical scenarios and actual surgical procedures. Therefore, future research should emphasize enhancing decision-making capabilities during real-time surgeries. Third, this study is a descriptive study and did not include a control group. Finally, the Likert scale may fail to capture genuine differences in competition motivation due to its limited sensitivity, susceptibility to response bias, and restricted construct coverage, potentially yielding a false impression of statistical non-differentiation. Future research should expand the sample size to include physicians from diverse regions and departments. Additionally, incorporating assessment items more closely aligned with clinical practice, such as competitions and training in simulated surgical scenarios that evaluate comprehensive skills, enables a more comprehensive evaluation of laparoscopic surgeons\u0026rsquo; skill levels and training effectiveness.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study found that young physicians in southern Zhejiang province demonstrate overall proficiency in laparoscopic skills. However, they remain relatively weak in performing technically demanding procedures that require completing operations ahead of schedule, with precision and fluidity within time constraints. Young physicians who actively prepare for competitions and hold high self-assessments of their laparoscopic skills significantly influence competition outcomes. Future laparoscopic training should consider enhancing systematic simulation training and fostering a learning-through-competition environment via skill contests to comprehensively elevate laparoscopic proficiency.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e \u003cp\u003e This retrospective study was approved by the Institutional Review Board (Ethics Committee) of Taizhou Hospital in Zhejiang Province (Approval No. K20251039). The requirement for written informed consent was waived by the Ethics Committee due to the use of anonymized and de-identified patient data. All data were analyzed in an aggregated and anonymous manner to protect patient privacy. This study was conducted in accordance with the ethical standards of the World Medical Association (Declaration of Helsinki) and the CHERRIES Statement.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003e All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eXiang Jin, Xinye Lin, Yiyu Chen, Weihong Zhao, Yang Yang, Junbo Liang, Weilin Li, have no conflict of interest or financial ties to disclose.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eA Research Project on the Application of Standardized Patients in Practical Teaching (T-2025006)\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eWeilin Li and Junbo Liang onceptualized and designed the study. Weihong Zhao and Yang Yang participated in the study design. Yiyu Chen collected some data. Xiang Jin and Xinye Lin collected data and was responsible for statistical analysis and manuscript writing.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe extend our gratitude to all authors for their significant contributions to this paper.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data and materials supporting the conclusions of this article can be obtained by contacting the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eYe SP, Zhu WQ, Huang ZX, Liu DN, Wen XQ, Li TY. Role of minimally invasive techniques in gastrointestinal surgery: Current status and future perspectives. World J Gastrointest Surg. 2021;13(9):941\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu M, Wang H, Zhang X, Shi J, Lan X, Mou T, Wang Y. 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Heliyon. 2023;9(5):e15942.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Laparoscope, Young Physicians, Skills Training, Simulation Training, Competition Motivation","lastPublishedDoi":"10.21203/rs.3.rs-8676149/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8676149/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAs a cornerstone of minimally invasive surgery, laparoscopy poses considerable operational challenges for surgeons. This study assessed the current laparoscopic skill level among young physicians in Southern Zhejiang (China) and identified influencing factors.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA multicenter cross-sectional survey was conducted, recruiting young physicians from 24 hospitals to participate in a three-module laparoscopic skills competition. Pre-competition questionnaires were collected for correlation analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong the 102 participants included in the skills assessment, 75 completed valid questionnaires. The mean total scores were as follows: circular cutting, 89.2\u0026thinsp;\u0026plusmn;\u0026thinsp;17.5 (Completion: 64.1\u0026thinsp;\u0026plusmn;\u0026thinsp;10.1; Technical: 18.1\u0026thinsp;\u0026plusmn;\u0026thinsp;7.3; Bonus: 5.6\u0026thinsp;\u0026plusmn;\u0026thinsp;6.8; 43.1% received no bonus); soybean transfer, 54.6\u0026thinsp;\u0026plusmn;\u0026thinsp;22.0 (Completion: 53.1\u0026thinsp;\u0026plusmn;\u0026thinsp;20.1; Bonus: 0.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5; 99% received no bonus); and fixed-point suturing, 83.2\u0026thinsp;\u0026plusmn;\u0026thinsp;20.0 (Completion: 60.0\u0026thinsp;\u0026plusmn;\u0026thinsp;14.7; Technical: 18.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.6; Bonus: 3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.3; 63.7% received no bonus). Regression analysis indicated that prior laparoscopic training was associated with better performance in fixed-point suturing (P\u0026thinsp;=\u0026thinsp;0.04). Cumulative training exceeding 30 hours correlated with higher scores in soybean transfer (P\u0026thinsp;=\u0026thinsp;0.05) and fixed-point suturing (P\u0026thinsp;=\u0026thinsp;0.04). Frequent simulation training significantly improved outcomes across all modules (P\u0026thinsp;=\u0026thinsp;0.03, 0.05, 0.04). Participants who self-rated as \u0026ldquo;able to proficiently complete tasks within the allotted time\u0026rdquo; achieved notably higher scores, particularly in soybean transfer and suturing (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). No significant associations were observed between performance and demographic characteristics such as motivation, gender, education, professional title, or years of experience (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eYoung physicians in Southern Zhejiang demonstrate general competency in laparoscopic skills but perform less effectively in time-sensitive, high-precision tasks. Future training should emphasize systematic simulation and competitive practice to comprehensively enhance proficiency.\u003c/p\u003e","manuscriptTitle":"A Study on the Current Status of Laparoscopic Skills Among Young Physicians: A Multicenter Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-13 17:46:35","doi":"10.21203/rs.3.rs-8676149/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-12T08:54:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"55724895529293352454368029989597525838","date":"2026-05-12T08:35:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"84192312613878581271189802876298232077","date":"2026-04-12T21:23:21+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-20T14:44:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"155747596562598438198417889503564188899","date":"2026-03-12T10:53:43+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-10T14:50:24+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-10T14:22:02+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-06T07:57:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-06T07:53:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2026-01-23T07:04:37+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9464d5f7-8dd8-4ab3-8e7f-e72294b462e4","owner":[],"postedDate":"March 13th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-12T08:54:52+00:00","index":105,"fulltext":""},{"type":"reviewerAgreed","content":"55724895529293352454368029989597525838","date":"2026-05-12T08:35:21+00:00","index":104,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-13T17:46:35+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-13 17:46:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8676149","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8676149","identity":"rs-8676149","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}