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Sadati L, Karami S, Edalattalab F, Hajati N, Azarsina S, Nouri Khaneghah Z, Abjar R. Designing, implementing, and evaluating a basic surgical skills bootcamp: An effective approach to enhance competency in surgical residency training. Surgeon 2024:S1479-666X(24)00089-1. [PMID: 39174363 DOI: 10.1016/j.surge.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/03/2024] [Accepted: 08/08/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION Recent technological advances have facilitated the development of new educational methods, such as simulation-based learning, in specialized bootcamps to enhance the learning of surgical residents. This study aimed to design, implement, and evaluate a basic surgical skills bootcamp for residents in general surgery, orthopedics, neurosurgery, and gynecology based on the learning gap in the current educational program. METHODS This intervention study focused on the design, implementation, and evaluation of a basic surgical skills bootcamp in a simulated operating room for first-year surgical residents in general surgery, orthopedics, neurosurgery, and gynecology. RESULTS The study resulted in the creation of a comprehensive course plan and the execution of a 6-day training program. Evaluation of educational outcomes confirmed high learner satisfaction, improvement in Multiple Choice Questions (MCQ) exam scores, and acceptable scores in the Objective Structured Clinical Examination (OSCE). CONCLUSION The findings of this study suggest that surgical bootcamps, when designed based on needs assessment and in line with scientific bootcamp design principles, play a crucial role in enhancing the satisfaction, knowledge, and skills of surgical residents.
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Affiliation(s)
- Leila Sadati
- Department of Operating Room, School of Paramedical Sciences, Alborz University of Medical Sciences, Karaj, Iran.
| | - Sahar Karami
- Medical Education Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Edalattalab
- School of Paramedical Sciences, Alborz University of Medical Sciences, Karaj, Iran.
| | - Niloofar Hajati
- Department of Operating Room, School of Paramedical Sciences, Alborz University of Medical Sciences, Karaj, Iran.
| | - Salman Azarsina
- Department of Orthopedics, School of Medicine, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran.
| | - Zahra Nouri Khaneghah
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Rana Abjar
- Department of Operating Room, School of Paramedical Sciences, Alborz University of Medical Sciences, Karaj, Iran.
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Pavone M, Lecointre L, Seeliger B, Oliva R, Akladios C, Querleu D, Scambia G, Marescaux J, Forgione A. The vaginal route for minimally invasive surgery: a practical guide for general surgeons. MINIM INVASIV THER 2024:1-10. [PMID: 38850263 DOI: 10.1080/13645706.2024.2359707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 04/21/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION Vaginal approaches have become routine in the field of gynecologic surgery, whereas in general surgery vaginal wall transection is an infrequent practice typically reserved for extensive tumor resections. Approximately two decades ago, natural orifice transluminal endoscopic surgery (NOTES) revolutionized conventional boundaries by accessing the peritoneal cavity transorally, transrectally, or transvaginally, enabling general surgery without visible scars. Although transvaginal approaches have been successfully used for various abdominal procedures by general surgeons, a gap remains in comprehensive training to fully exploit the potential of this route. MATERIAL AND METHODS PubMed, Google Scholar, and Scopus databases were searched to retrieve relevant articles illustrating how general surgeons can adeptly manage vaginal approaches. RESULTS The article presents a practical framework for general surgeons to execute a complete vaginal approach, addressing the management of vaginal specimen extraction and vaginal cuff closure, even in the absence of an experienced gynecologist. CONCLUSION The evolution of abdominal surgery is moving towards less invasive techniques, emphasizing the importance of understanding the nuances and challenges associated with the vaginal route. This approach is linked to minimal oncological, sexual, and infective complications, and to the absence of pregnancy-related complications. Such knowledge becomes increasingly crucial, particularly with the renewed demand for transvaginal access in robot-assisted NOTES procedures.
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Affiliation(s)
- Matteo Pavone
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
- IHU Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy
| | - Lise Lecointre
- IHU Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Department of Gynecologic Surgery, University Hospital of Strasbourg, Strasbourg, France
- ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France
| | - Barbara Seeliger
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
- IHU Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France
- Department of Digestive and Endocrine Surgery, University Hospitals of Strasbourg, Strasbourg, France
| | - Riccardo Oliva
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy
| | - Cherif Akladios
- Department of Gynecologic Surgery, University Hospital of Strasbourg, Strasbourg, France
| | - Denis Querleu
- IHU Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy
- ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France
| | - Giovanni Scambia
- Dipartimento di Scienze per la salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy
| | - Jacques Marescaux
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
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Wesevich A, De Fer TM, Awad MM, Woodhouse J, Andriole DA, Brunt LM. A Capstone Course for Senior Medical Students: from Innovative Elective to Required Core Curriculum. MEDICAL SCIENCE EDUCATOR 2024; 34:171-180. [PMID: 38510417 PMCID: PMC10948630 DOI: 10.1007/s40670-023-01880-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 03/22/2024]
Abstract
We describe our institution's development and implementation of our Capstone course from a small elective course to the only required fourth-year course. The course's structure evolved from mostly didactic to one including various workshops and simulation sessions. Course content has become increasingly specialty-specific. Implementation requires high faculty and resident involvement. Evaluations indicate a positive impact of the course on participants' self-reported confidence and residency preparedness. Assessment remains pass/fail with more specialty-specific questions. As steadily increasing numbers of medical schools are developing transition to residency courses, we share our Capstone course's evolution and lessons learned over the past nine years. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01880-2.
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Affiliation(s)
- Austin Wesevich
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL USA
| | - Thomas M. De Fer
- Department of Medicine, Washington University School of Medicine, St. Louis, MO USA
| | - Michael M. Awad
- Department of Surgery, Washington University School of Medicine, St. Louis, MO USA
| | - Julie Woodhouse
- Office of Education, Washington University School of Medicine, St. Louis, MO USA
| | - Dorothy A. Andriole
- Medical Education Research, Association of American Medical Colleges, Washington, D.C. USA
| | - L. Michael Brunt
- Department of Surgery, Washington University School of Medicine, St. Louis, MO USA
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Fu MZ, Islam R, DeMarzo J, Lichtbroun B, Tabakin AL, Park JH, Elsamra SE. The Boot Camp Model in Urology: Preparing PGY1 Urology Interns for Practice. Curr Urol Rep 2023; 24:553-559. [PMID: 37749358 DOI: 10.1007/s11934-023-01186-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight literature regarding resident boot camps published across surgical specialties with a focus on urology. Herein, we discuss different boot camp iterations, their results, and the integration of simulation into their curriculum. We review program elements such as curriculum, course length, and efficacy as well as areas for continued investigation. RECENT FINDINGS The field of urology has grown in both the breadth of knowledge and the complexity of procedures. With urology now being an integrated surgical subspecialty, interns often start on the urology service despite limited experience navigating this unique specialty. The boot camp model is one method by which interns and junior residents participate in consolidated training programs to best prepare them for a patient-facing role and the day-to-day demands of residency. Urology programs, both in the USA and abroad, have begun integrating boot camps into their training programs with positive results. Urology boot camps can be a valuable part of training programs for interns to quickly establish medical knowledge, skills, and efficiency. Boot camps should be easily accessible, have sufficient support from institutions, and provide effective training through various methods such as didactics and simulation.
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Affiliation(s)
- Melinda Z Fu
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Raeesa Islam
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Joseph DeMarzo
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Benjamin Lichtbroun
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Alexandra L Tabakin
- Division of Female Pelvic Medicine and Reconstructive Surgery, Donald and Barbara Zucker School of Medicine and Hofstra/Northwell, Great Neck, NY, USA
| | - Ji Hae Park
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Sammy E Elsamra
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA.
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Gervais V, Grabs D, Bougie E, Salib GE, Bortoluzzi P, Tremblay DM. The Montreal Plastic Surgery Residency Bootcamp: Structure and Utility. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5337. [PMID: 37829103 PMCID: PMC10566876 DOI: 10.1097/gox.0000000000005337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 08/29/2023] [Indexed: 10/14/2023]
Abstract
Transitioning from medical school to surgical residency is a difficult endeavor. To facilitate this period, the University of Montreal's plastic surgery program developed and implemented an intensive 1-month bootcamp rotation. It is the only one of its kind and length amongst plastic surgery residency programs in North America. It includes didactic teachings in anatomy, cadaveric dissections, and surgical approaches for an array of procedures. Clinical and technical skills are reviewed with senior residents and attending surgeons. Research opportunities and case scenarios are also covered. An anonymous online 30-question survey was sent to all residents who participated in the bootcamp rotation between 2013 and 2020. Questions evaluated residents' knowledge of anatomy, basic surgical skills, common approaches, flap knowledge, and on-call case management, before and after the bootcamp. Seventeen plastic surgery residents responded to this questionnaire (81%). The majority confirmed that the bootcamp helped them prepare for residency, research, and on-calls, and also helped them expand their knowledge of anatomy and surgical skills. The residents responded positively to the bootcamp's structure and implementation. This study proposes that surgical programs could benefit from a bootcamp rotation at the beginning of their curriculum. The purpose is to facilitate the transition between medical school and postgraduate training, and to ensure a basic level of competence for all junior residents. Further prospective studies could demonstrate the bootcamp's impact in board certification rates and acceptance into fellowship training programs.
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Affiliation(s)
- Valerie Gervais
- From the Department of Plastic Surgery, CIUSSS de l’Est-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Detlev Grabs
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Emilie Bougie
- Department of Plastic Surgery, CHU Ste-Justine, Montréal, QC, Canada
| | - George E. Salib
- Department of Plastic Surgery, Centre hospitalier affilié universitaire régional de Trois-Rivières, Trois-Rivières, QC, Canada
| | | | - Dominique M. Tremblay
- From the Department of Plastic Surgery, CIUSSS de l’Est-de-l’Île-de-Montréal, Montréal, QC, Canada
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Singer KE, Baker JE, Elson NC, Wallen TE, Salvator A, Quillin RC, Sussman JJ, Makley AT, Goodman MD. How Informed Is Your Informed Consent: Evaluating Differences Between Resident and Attending Obtained Consents for Cholecystectomy. JOURNAL OF SURGICAL EDUCATION 2022; 79:1509-1515. [PMID: 36030182 DOI: 10.1016/j.jsurg.2022.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/24/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE There is considerable variability in surgeons' approach to write and obtain informed consent for surgery, particularly among resident trainees. We analyzed differences in procedures and complications described in documented surgical consents for cholecystectomy between residents and attendings. We hypothesized that attending consents would describe more comprehensive procedures and complications than those done by residents. DESIGN This is a retrospective analysis of 334 patients who underwent cholecystectomy. Charts were queried for demographics, surgical approach, whether the consent was completed electronically, and which provider completed the consent. Specifically, consents were evaluated for inclusion of possible conversion to open procedure, intraoperative cholangiogram, bile duct injury, injury to nearby structures, reoperation, bile leak, as well as if the consent matched the actual procedure performed. SETTING This study was conducted at an accredited general surgery training program at an academic tertiary care center in the Midwest. PARTICIPANTS This was a review of 334 patients who underwent cholecystectomy over a 1 year period. RESULTS Of all documented consents analyzed, 153 (47%) specifically included possible intraoperative cholangiogram, 156 (47%) included bile duct injury, 76 (23%) included injury to nearby structures, 22 (7%) included reoperation, and 62 (19%) included bile leak. In comparing residents and attendings, residents were more likely to consent for bile duct injury (p = 0.002), possible intraoperative cholangiogram (p = 0.0007), injury to nearby structures (p < 0.0001), reoperation (p < 0.0001), and bile leak (p < 0.0001). CONCLUSIONS Significant variation exists between documentation between resident and attending cholecystectomy consents, with residents including more complications than attendings on their consent forms. These data suggest that experience alone does not predict content of written consents, particularly for common ambulatory procedures. Education regarding the purpose of informed consent and what should be included in one may lead to a reduction in variability between providers.
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Affiliation(s)
- Kathleen E Singer
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Jennifer E Baker
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Nora C Elson
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Taylor E Wallen
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Ann Salvator
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Ralph C Quillin
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Jeffrey J Sussman
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Amy T Makley
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Michael D Goodman
- Department of General Surgery, University of Cincinnati, Cincinnati, Ohio.
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Baird R, Puligandla P, Lopushinsky S, Blackmore C, Krishnaswami S, Nwomeh B, Downard C, Ponsky T, Ghani MO, Lovvorn HN. Virtual curriculum delivery in the COVID-19 era: the pediatric surgery boot camp v2.0. Pediatr Surg Int 2022; 38:1385-1390. [PMID: 35809106 PMCID: PMC9455938 DOI: 10.1007/s00383-022-05156-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE We evaluated the impact of a virtual Pediatric Surgery Bootcamp curriculum on resource utilization, learner engagement, knowledge retention, and stakeholder satisfaction. METHODS A virtual curriculum was developed around Pediatric Surgery Milestones. GlobalCastMD delivered pre-recorded and live content over a single 10-h day with a concluding social hour. Metrics of learner engagement, faculty interaction, knowledge retention, and satisfaction were collected and analyzed during and after the course. RESULTS Of 56 PS residencies, 31 registered (55.4%; 8/8 Canadian and 23/48 US; p = 0.006), including 42 learners overall. The virtual BC budget was $15,500 (USD), 54% of the anticipated in-person course. Pre- and post-tests were administered, revealing significant knowledge improvement (48.6% [286/589] vs 66.9% [89/133] p < 0.0002). Learner surveys (n = 14) suggested the virtual BC facilitated fellowship transition (85%) and strengthened peer-group camaraderie (69%), but in-person events were still favored (77%). Program Directors (PD) were surveyed, and respondents (n = 22) also favored in-person events (61%). PDs not registering their learners (n = 7) perceived insufficient value-added and concern for excessive participants. CONCLUSIONS The virtual bootcamp format reduced overall expenses, interfered less with schedules, achieved more inclusive reach, and facilitated content archiving. Despite these advantages, learners and program directors still favored in-person education. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Robert Baird
- Department of Pediatric Surgery, BC Children’s Hospital University of British Colombia, Ambulatory Care Bldg, K0-134, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | - Pramod Puligandla
- Department of Pediatric Surgery, Montreal Children’s Hospital, McGill University, Montreal, CA Canada
| | - Steven Lopushinsky
- Section of Pediatric Surgery, Alberta Children’s Hospital, University of Calgary, Calgary, CA Canada
| | - Christopher Blackmore
- Division of Pediatric General and Thoracic Surgery, IWK Health Centre, Dalhousie University, Halifax, NS Canada
| | - Sanjay Krishnaswami
- Division of Pediatric Surgery, Doernbecher Children’s Hospital, Oregon Health and Science University, Portland, OR USA
| | - Benedict Nwomeh
- Department of Pediatric Surgery, Nationwide Children’s Hospital, Ohio State University, Columbus, OH USA
| | - Cynthia Downard
- Division of Pediatric Surgery, Hiram C Polk, Jr, MD Department of Surgery, University of Louisville, Norton Children’s Hospital, Louisville, KY USA
| | - Todd Ponsky
- Division of Pediatric Surgery, Cincinnati Children’s Hospital, University of Cincinnati, Cincinnati, OH USA
| | - Muhammad O. Ghani
- Department of Pediatric Surgery, Monroe Carell, Jr. Children’s Hospital at Vanderbilt, Nashville, TN USA
| | - Harold N. Lovvorn
- Department of Pediatric Surgery, Monroe Carell, Jr. Children’s Hospital at Vanderbilt, Nashville, TN USA
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Mehrotra D, Markus A. Emerging simulation technologies in global craniofacial surgical training. J Oral Biol Craniofac Res 2021; 11:486-499. [PMID: 34345584 PMCID: PMC8319526 DOI: 10.1016/j.jobcr.2021.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022] Open
Abstract
The last few decades have seen an exponential growth in the development and adoption of novel technologies in medical and surgical training of residents globally. Simulation is an active and innovative teaching method, and can be achieved via physical or digital models. Simulation allows the learners to repeatedly practice without the risk of causing any error in an actual patient and enhance their surgical skills and efficiency. Simulation may also allow the clinical instructor to objectively test the ability of the trainee to carry out the clinical procedure competently and independently prior to trainee's completion of the program. This review aims to explore the role of emerging simulation technologies globally in craniofacial training of students and residents in improving their surgical knowledge and skills. These technologies include 3D printed biomodels, virtual and augmented reality, use of google glass, hololens and haptic feedback, surgical boot camps, serious games and escape games and how they can be implemented in low and middle income countries. Craniofacial surgical training methods will probably go through a sea change in the coming years, with the integration of these new technologies in the surgical curriculum, allowing learning in a safe environment with a virtual patient, through repeated exercise. In future, it may also be used as an assessment tool to perform any specific procedure, without putting the actual patient on risk. Although these new technologies are being enthusiastically welcomed by the young surgeons, they should only be used as an addition to the actual curriculum and not as a replacement to the conventional tools, as the mentor-mentee relationship can never be replaced by any technology.
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Affiliation(s)
- Divya Mehrotra
- Department of Oral and Maxillofacial Surgery KGMU, Lucknow, India
| | - A.F. Markus
- Emeritus Consultant Maxillofacial Surgeon, Poole Hospital University of Bournemouth, University of Duisburg-Essen, Trinity College, Dublin, Ireland
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