Laparoscopic Skills Training and Learning Curve Among Surgical Residents in Nigeria: A Multi-Centre Empirical Study

The acquisition of laparoscopic surgical skills follows a predictable learning curve, yet the factors influencing this trajectory among Nigerian surgical residents in resource-limited training environments have not been empirically characterised. This multi-centre study investigates the laparoscopic skills learning curve among postgraduate surgical residents in Nigeria, using validated simulation assessment tools across training institutions in three geopolitical zones. Seventy-five surgical residents in PGY-2 to PGY-5 from teaching hospitals in Lagos, Abuja, and Enugu were recruited. Each resident underwent structured simulation training on a box trainer, with performance assessed at baseline, 4 weeks, and 8 weeks using the Fundamentals of Laparoscopic Surgery (FLS) tool. Video task completion time, error rates, and economy of movement were tracked. Significant performance improvement was observed across all metrics at 8 weeks (p<0.001). Residents who had previously observed more than 20 laparoscopic procedures showed accelerated skill acquisition. Access to simulation equipment beyond formal training sessions was a key determinant of improvement rate. Mentorship quality was significantly associated with learning curve steepness. The study provides empirical benchmarks for Nigerian residency programs and recommends mandatory FLS-based simulation modules, increased access to box trainers, and structured laparoscopic mentorship programs in postgraduate surgical training. Keywords: laparoscopic training, learning curve, FLS, surgical residents, simulation