Do consultants want e-learning in plastic surgery for continuing professional development and revalidation?

Doctors' attitudes to maintenance of professional competence: A scoping review

CONTEXT

Recent decades have seen the international implementation of programmes aimed at assuring the continuing competence of doctors. Maintenance of Professional Competence (MPC) programmes aim to encourage doctors' lifelong learning and ensure high-quality, safe patient care; however, programme requirements can be perceived as bureaucratic and irrelevant to practice, leading to disengagement. Doctors' attitudes and beliefs about MPC are critical to translating regulatory requirements into committed and effective lifelong learning. We aimed to summarise knowledge about doctors' attitudes to MPC to inform the development of MPC programmes and identify under-researched areas.

METHODS

We undertook a scoping review following Arksey and O'Malley, including sources of evidence about doctors' attitudes to MPC in the United States, the United Kingdom, Canada, Australia, New Zealand and Ireland, and using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) as a guide.

RESULTS

One hundred and twenty-five sources of evidence were included in the review. One hundred and two were peer-reviewed publications, and 23 were reports. Most were from the United Kingdom or the United States and used quantitative or mixed methods. There was agreement across jurisdictions that MPC is a good idea in theory but doubt that it achieves its objectives in practice. Attitudes to the processes of MPC, and their impact on learning and practice were mixed. The lack of connection between MPC and practice was a recurrent theme. Barriers to participation were lack of time and resources, complexity of the requirements and a lack of flexibility in addressing doctors' personal and professional circumstances.

CONCLUSIONS

Overall, the picture that emerged is that doctors are supportive of the concept of MPC but have mixed views on its processes. We highlight implications for research and practice arising from these findings.

Research priorities in light of current trends in microsurgical training: revalidation, simulation, cross-training, and standardisation

Plastic surgery training worldwide has seen a thorough restructuring over the past decade, with the introduction of formal training curricula and work-based assessment tools. Part of this process has been the introduction of revalidation and a greater use of simulation in training delivery. Simulation is an increasingly important tool for educators because it provides a way to reduce risks to both trainees and patients, whilst facilitating improved technical proficiency. Current microsurgery training interventions are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess the potential benefits of alternative models, particularly cross-training, a model now widely used in non-medical areas with significant benefits. Furthermore, with the proliferation of microsurgery training interventions and therefore diversity in length, cost, content and models used, appropriate standardisation will be an important factor to ensure that courses deliver consistent and effective training that achieves appropriate levels of competency. Key research requirements should be gathered and used in directing further research in these areas to achieve on-going improvement of microsurgery training.

E-Learning and Multimedia Contents for Minimally Invasive Surgery Learning

Background: Minimally Invasive Surgery has revolutionized the surgical practice for the last years but it presents specific training processes. At the same time, e-Learning platforms and multimedia contents are now having great success within teaching processes in different fields. Purpose: to determine perception of surgeons towards e-MIS: e-Learning and multimedia contents for minimally invasive surgery. Methods: A 19-item online survey was sent. Statistical and descriptive analyses were performed. Results: 307 surgeons responded to the survey. 99% of participants agree to include new technologies in surgical learning and 99.3% consider surgical videos as a good training tool. Conclusion: The widespread use and capabilities of e-Learning together with the use of surgical videos within the surgical learning process makes possible creating new technological systems and tools that address current problems in surgical training derived from time constraints and patient safety concerns.

Is there a digital generation gap for e-learning in plastic surgery?

BACKGROUND

Some authors have claimed that those plastic surgeons born between 1965 and 1979 (generation X, or Gen-X) are more technologically able than those born between 1946 and 1964 (Baby Boomers, or BB). Those born after 1980, which comprise generation Y (Gen-Y), might be the most technologically able and most demanding for electronic learning (e-learning) to support their education and training in plastic surgery. These differences might represent a "digital generation gap" and would have practical and financial implications for the development of e-learning.

OBJECTIVES

The aim of this study was to survey plastic surgeons on their experience and preferences in e-learning in plastic surgery and to establish whether there was a difference between different generations.

DESIGN

Online survey (e-survey) of plastic surgeons within the UK and Ireland was used for this study.

METHODS

In all, 624 plastic surgeons were invited by e-mail to complete an e-survey anonymously for their experience of e-learning in plastic surgery, whether they would like access to e-learning and, if so, whether this should this be provided nationally, locally, or not at all. By stratifying plastic surgeons into three generations (BB, Gen-X, and Gen-Y), the responses between generations were compared using the χ(2)-test for linear trend. A p value < 0.05 was considered to be statistically significant.

RESULTS

Of the 624 plastic surgeons contacted, 237 plastic surgeons completed the survey (response rate, 38%), but data from 2 surgeons were excluded. For the remaining 235 plastic surgeons, no evidence was found of statistically significant linear trends between by generation and either experience, access, or provision of e-learning.

CONCLUSIONS

These findings refute the claim that there are differences in the experience of e-learning of plastic surgeons by generation. Furthermore, there is no evidence that there are differences in whether there should be access to e-learning and how e-learning should be provided for different generations of plastic surgeons.