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Wczysla K, Sparn M, Schmied B, Hahnloser D, Bischofberger S. There is a need for a paradigm shift in laparoscopic surgical training: results of a nationwide survey among teaching hospitals in Switzerland. BMC Med Educ 2024; 24:205. [PMID: 38413927 PMCID: PMC10900659 DOI: 10.1186/s12909-024-05209-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/21/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Surgical training curricula have changed little over the past decades. Current advances in surgical techniques, especially in minimally invasive surgery, as well as the rapidly changing socioeconomic environment pose a major challenge for the training of young surgeons. The aim of this survey was to provide a representative overview of the surgical training landscape in Switzerland focusing on laparoscopic surgical training: How do department chairs of teaching hospitals deal with the above challenges, and what should a future training curriculum look like? METHODS This is a prospective, questionnaire-based, cross-sectional study among the heads of departments of all certified surgical teaching hospitals in Switzerland. RESULTS The overall response rate was 56% (48/86) and 86% (19/22) for tertiary centers. Two-thirds of the centers (32) organize themselves in training networks. Laparoscopic training courses are offered in 25 (52%) hospitals, mainly in tertiary centers. Self-training opportunities exist in 40 (83%) hospitals. In addition to commercial (27) and self-built (7) box trainers, high-fidelity trainers are available in 16 (33%) hospitals. A mandatory training curriculum exists in 7 (15%) facilities, and a training assessment is performed in 15 (31%) institutions. Thirty-two (65%) heads of departments indicated that residents have sufficient practical exposure in the operating room, but the ability to work independently with obtaining the specialist title is seen critically (71%). They state that the surgical catalog does not adequately reflect the manual skills of the resident (64%). The desire is for training to be restructured from a numbers-based to a performance-based curriculum (53%) and for tools to assess residents' manual skills (56%) to be introduced. CONCLUSIONS Department chairs stated that the existing curriculum in Switzerland does not meet the requirements of a modern training curriculum. This study highlights the need to create an improved, competency-based curriculum that ensures the training of a new generation of surgeons, taking into account the growing evidence of the effectiveness of state-of-the-art training modalities such as simulation or proficiency-based training.
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Affiliation(s)
- Karolina Wczysla
- Department of Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland
| | - Moritz Sparn
- Department of Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland
| | - Bruno Schmied
- Department of Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland
| | - Dieter Hahnloser
- Department of Surgery, Centre Hôpitalier Universitaire Vaudois, CH-1011, Lausanne, Switzerland
| | - Stephan Bischofberger
- Department of Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland.
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Jeffery CS, Stewart KE, Hayhurst JL, Hall CM, Regner JL, Raines AR. Survey shows all surgical residents have exposure to robotic surgery yet no formalized curricula exist amongst programs: A Southwest Surgical Congress Survey. Am J Surg 2023; 226:878-881. [PMID: 37558517 DOI: 10.1016/j.amjsurg.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/10/2023] [Accepted: 07/22/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Increased robotic surgery exposure during general surgery training occurs at many institutions without a formal education curriculum. Our study evaluates the current state of general surgery robotic training within programs represented by the Southwestern Surgical Congress (SWSC). METHODS A web-based survey regarding robot-assisted surgery (RAS) and general surgery training was developed and sent to member institutions of the SWSC. General surgery program directors were asked to voluntarily complete the survey. Results were evaluated in aggregate. Descriptive analysis was used. RESULTS In total, 28 programs responded. All reported resident exposure to RAS during training. Case mix was diverse with exposure to multiple general surgical subspecialties. 89% of programs reported the presence of a formal RAS curriculum, however, only 53% reported recognition of training completion. Case volumes also varied amongst programs with 46% of programs reporting residents logging 21-40 cases and 35% logging more than 40 cases in total. CONCLUSION Exposure to RAS among SWSC residency programs is ubiquitous, however, there is significant variation between programs in case volumes, case types, and elements of RAS curricula.
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Affiliation(s)
- Christopher S Jeffery
- University of Oklahoma College of Medicine, Department of Surgery, 800 Stanton L. Young Blvd., Suite 9000, Oklahoma City, OK, 73104, USA.
| | - Kenneth E Stewart
- University of Oklahoma College of Medicine, Department of Surgery, 800 Stanton L. Young Blvd., Suite 9000, Oklahoma City, OK, 73104, USA.
| | - Joseph L Hayhurst
- University of Oklahoma College of Medicine, Department of Surgery, 800 Stanton L. Young Blvd., Suite 9000, Oklahoma City, OK, 73104, USA.
| | - Chad M Hall
- Baylor Scott & White Health, Department of Surgery, 2401 S. 31st St, Temple, TX, 76508, USA.
| | - Justin L Regner
- Baylor Scott & White Health, Department of Surgery, 2401 S. 31st St, Temple, TX, 76508, USA.
| | - Alexander R Raines
- University of Oklaoma College of Medicine, Department of Surgery, 800Stanton L. Young Blvd, Ste 9000, Oklahoma City, OK, 73104, USA.
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Nguyen G, Balasubramanian TH, Shah DM, Odolil AS, Palmer J, Levin MR, Swamy R, Alexander JL. Quality assessment of polymer materials for human model eye development. Int Ophthalmol 2023:10.1007/s10792-023-02736-9. [PMID: 37217809 DOI: 10.1007/s10792-023-02736-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/06/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE We developed model eyes using six polymer materials to determine which materials were most appropriate in simulating real human sclera and extraocular muscle (EOM). METHODS Five three-dimensional (3-D) printed polymers (FlexFill, PolyFlex, PCTPE, Soft PLA, and NinjaFlex) and one silicone material were systematically tested by board-certified ophthalmologists and senior ophthalmology residents. Material testing included scleral passes with 6-0 Vicryl sutures through each eye model. Participants completed a survey designed to collect demographic data, subjective assessment of each material's accuracy in simulating real human sclera and EOM, and a ranking for each polymer material to identify which would be most suitable for an ophthalmic surgery training tool. The Wilcoxon signed-rank test was conducted to determine if there was a statistically significant difference in the distribution of ranks between the polymer materials. RESULTS The distribution of ranks for silicone material's "sclera" and "EOM" components were statistically significantly higher than that of all other polymer materials (all p < 0.05). Silicone material received the highest rank for both "sclera" and "EOM" components. Survey results indicated that the silicone material effectively simulated real human tissue. CONCLUSION Silicone model eyes performed better than 3-D printed polymers as an educational tool for incorporation into a microsurgical training curriculum. Silicone models provide a low-cost teaching tool that allows for independent practice of microsurgical techniques without requiring a wet-laboratory facility.
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Affiliation(s)
- Geoffrey Nguyen
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Dhruv M Shah
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Abel S Odolil
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 W. Redwood St., Suite 479, Baltimore, MD, 21201, USA
| | - Jamie Palmer
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Moran R Levin
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 W. Redwood St., Suite 479, Baltimore, MD, 21201, USA
| | - Ramya Swamy
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 W. Redwood St., Suite 479, Baltimore, MD, 21201, USA
| | - Janet Leath Alexander
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 W. Redwood St., Suite 479, Baltimore, MD, 21201, USA.
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Stockheim J, Perrakis A, Sabel BA, Waschipky R, Croner RS. RoCS: Robotic Curriculum for young Surgeons. J Robot Surg 2022; 17:495-507. [PMID: 35810233 PMCID: PMC10076401 DOI: 10.1007/s11701-022-01444-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/26/2022] [Indexed: 11/26/2022]
Abstract
Robotic-assisted procedures gain increasing acceptance for daily surgical routine. However, structured training programs are designed for surgeons with high expertise. Hence, a comprehensive training curriculum was established to ensure a basic competence in robotic abdominal surgery for young surgeons during their residency. The aim of the current work is to propose a feasible and effective training concept. The development process of this training curriculum is based on a comprehensive literature review which led to the concept of "robotic curriculum for young surgeons" (RoCS). It was implemented in the daily routine of a German university hospital starting in 2020. The robotic assessment questionnaire (RAQ) was used for electronic data collection. After the initial phase adjustments, it led to an improvement of the initial version of the curriculum. RoCS is a multimodal training program containing basic training through assistance at the operation table during robotic-assisted operations and basic console training. Key elements are the robotic team time-out (rTTO), perioperative process standardization including feasible personnel scheduling and useful procedure clustering into organ systems, procedural steps and procedural step complexity. Evaluation of standardized communication, performance assessment, patient factors and individual overall workload using NASA Task Load Index is realizable. Flexibility and adaptability to internal organization processes of surgical departments are the main advantages of the concept. RoCS is a strong training tool to meet the specific needs of young surgeons and evaluate their learning success of robotic procedural training. Furthermore, comparison within the different robotic systems should be considered. Further studies are needed to validate a multicenter concept design.
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Affiliation(s)
- Jessica Stockheim
- Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Magdeburg, Otto-Von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
| | - Aristotelis Perrakis
- Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Magdeburg, Otto-Von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Bernhard A Sabel
- Institute of Medical Psychology, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany
| | - Robert Waschipky
- Department of Information Technology (IT) and Medical Engineering, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany
| | - Roland S Croner
- Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Magdeburg, Otto-Von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
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Feeley A, Feeley I, Carroll A, Hehir DJ. Student Acceptance of Virtual Bedside Surgical Tutorials During COVID-19: A Randomized Controlled Trial. J Surg Res 2022; 270:261-265. [PMID: 34715537 PMCID: PMC8548086 DOI: 10.1016/j.jss.2021.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/05/2021] [Accepted: 09/23/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The social distancing recommendations from the WHO during the pandemic has resulted in a pivot point in the delivery of medical education. With the medical student clinical experience constantly under threat; novel methods to maintain adequate surgical patient exposure and student interaction on a platform amenable to the interactive format required were devised using a virtual platform to compliment current pedagogical approaches. METHODS A parallel randomized controlled trial evaluated the perceived use of remote learning in place of bedside teaching. Participants were randomized to undergo surgical bedside teaching in person or virtually. Feedback questionnaires and exit interviews carried out following each session. Content analysis of transcripts was performed to evaluate the presence and quality of perceived learning, benefits and limitations to each modality. RESULTS Feedback demonstrated greater engagement, satisfaction, involvement and learning (P < 0.001) in the bedside teaching group. Content analysis yielded three main themes; Technological, Interpersonal Component, Provision of Content. Participants in the virtual group reported a limited ability to elicit clinically relevant findings in surgical patients. Students however reported the virtual teaching was an acceptable method of learning with 90% satisfaction reported for learning via the virtual platform. DISCUSSION The pandemic posed challenges to adequate student-patient exposure. Delivering surgical bedside teaching remotely is a method amenable to learning for students, with advantages including convenience, fewer reports of information fatigue, and decreased perceived pressure identified with this learning modality.
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Affiliation(s)
- Aoife Feeley
- Corresponding author. Midlands Regional Hospital Tullamore, Co. Offaly, Ireland
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Wu SJ, Fan YF, Sun S, Chien CY, Wu YJ. Perceptions of medical students towards and effectiveness of online surgical curriculum: a systematic review. BMC Med Educ 2021; 21:571. [PMID: 34763706 PMCID: PMC8582331 DOI: 10.1186/s12909-021-03014-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/01/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Online education has been used as an adjunct modality for teaching and it attracts attention in recent years as many medical students can not accomplish their clerkship in the hospital due to COVID-19 pandemic. This study aims to collect the articles related to online surgical education for medical students, and to analyze the effectiveness of online education and the perceptions of the medical students. METHOD We performed a systemic literature search in PubMed, MEDLINE, EMBASE, ERIC and Cochrane library. Keywords used for searching included "medical student", "online education", "online teaching", "online learning", "distance learning", "electronic learning", "virtual learning" and "surgical". Medical education research study quality instrument (MERSQI) was used for the evaluation of the quality of the searched articles. RESULTS From 1240 studies retrieved from the databases, 13 articles were included in this study after screening. The publication year was from 2007 to 2021. The mean MERSQI score of the 13 searched articles was 12.5 +/- 1.7 (range 10.0-14.5). There were totally 2023 medical students who attended online surgical curriculum. By online course, improvement of understanding and knowledge on the studied topics could be reached. The confidence in patient encounters could be improved by online curriculum with sharing experiences, discussing, and role playing. However, students felt concentration was poor during online course. Medical students studying through video platform could get better test scores than those studying with textbooks. Regarding basic surgical skills, online teaching of suturing and knot-tying could be possible and was appreciated by the students who could practice away from the hospital and get feedbacks by instructors through online environment. The scores for the clinical competence assessment for incision, suturing and knot-tying were found to be no significant difference between the online teaching group and face-to-face teaching group. CONCLUSION Online surgical curriculum for medical students is not easy but inevitable in the era of COVID-19 pandemic. Although online course is not the same as physical course, there are some efforts which could be tried to increase the effectiveness. Basic surgical skills could also be taught effectively through online platform. Even if the COVID-19 pandemic is over in the future, online curriculum could still be a helpful adjunct for surgical education.
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Affiliation(s)
- Shye-Jao Wu
- Division of Cardiovascular Surgery, Department of Surgery, MacKay Memorial Hospital, No.92, Sec 2, Chung-Shan N Road, Taipei, 104, Taiwan.
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan.
| | - Ya-Fen Fan
- Division of Cardiovascular Surgery, Department of Surgery, MacKay Memorial Hospital, No.92, Sec 2, Chung-Shan N Road, Taipei, 104, Taiwan
| | - Shen Sun
- Division of Cardiovascular Surgery, Department of Surgery, MacKay Memorial Hospital, No.92, Sec 2, Chung-Shan N Road, Taipei, 104, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
| | - Chen-Yen Chien
- Division of Cardiovascular Surgery, Department of Surgery, MacKay Memorial Hospital, No.92, Sec 2, Chung-Shan N Road, Taipei, 104, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
| | - Yih-Jer Wu
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Cardiovascular Center, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
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Husnoo N, Johnston J, Harikrishnan A. Incorporation of Evidence-Based Surgery into the Curriculum. Indian J Surg 2021;:1-4. [PMID: 34334975 DOI: 10.1007/s12262-021-03038-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022] Open
Abstract
Surgeons have historically learned their craft through the apprenticeship model from their mentors. Knowledge and practices acquired this way can rapidly become outdated. Providing high-quality care to patients requires surgeons to keep their knowledge up to date in line with evolving new evidence. The principles of evidence-based medicine (EBM) and its application to surgery, evidence-based surgery (EBS), are pivotal in updating and refining surgical practice. Changing from the conventional practice of surgical education to a structured evidence-based format requires a transformative process in all the levels of surgical practice encompassing trainees and trainers. Equally important is providing an optimal environment to review the evidence and deliver the surgical teaching and incorporate effective assessment tools to monitor the process. In this article, we revisit the levels of evidence and explore the different issues related to EBS such as barriers to EBS, incorporation of EBS to the surgical curriculum and discuss practical ways to implement EBS in the surgical curriculum.
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Huckaby LV, Cyr AR, Lee K, Steiman JG. The Life After Surgical Residency (LASR) Curriculum for Surgical Residents: Addressing the Nonclinical Barriers to Preparedness for Independent Practice. J Surg Educ 2020; 77:254-259. [PMID: 31722845 PMCID: PMC9057454 DOI: 10.1016/j.jsurg.2019.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/14/2019] [Accepted: 09/30/2019] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Extrinsic burdens, including new personal and professional responsibilities, may distract from early career success. We sought to assess resident preparedness in nonclinical topics and to utilize this data to design a curriculum to address these content areas. DESIGN All residents were surveyed to ascertain their self-reported preparedness on a variety of nonclinical topics (teaching, finances, contract negotiation, real estate, etc.). Using our survey results, a monthly curriculum was designed and implemented for senior residents based on these knowledge gaps. SETTING University-based general surgery residency program. PARTICIPANTS All general surgery residents. RESULTS Residents reported low levels of preparedness on the topics of contract negotiation and practice management and high levels of preparedness on the topics of teaching and money management. Following curriculum implementation, statistically significant improvement was noted in the topics of contract negotiation and academic pursuits. CONCLUSIONS Residents report low levels of preparedness in many nonclinical topics that may represent potentially modifiable stressors that can impact career success. Implementation of a directed curriculum improves sense of preparedness and may promote wellness among surgical trainees.
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Affiliation(s)
- Lauren V Huckaby
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Anthony R Cyr
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Kenneth Lee
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jennifer G Steiman
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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ASiT Medical Student and Foundation Doctor Consensus Group., Authorship consensus group., Steering group., Writing group., Consensus exercise participants., External advisory group. Core content of the medical school surgical curriculum: Consensus report from the association of surgeons in training (ASIT). Int J Surg 2020; 84:186-93. [PMID: 31926325 DOI: 10.1016/j.ijsu.2019.12.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/19/2019] [Accepted: 12/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The length of time dedicated to the undergraduate surgical curriculum is decreasing. With reduced time on surgical placements, students may be underexposed to their core learning needs. The aim of this study was to reach a national consensus on the core content of the undergraduate surgical curriculum in the UK. This will support medical students and medical schools in designing curricula to meet the core learning needs of students to prepare them for clinical practice. MATERIALS AND METHODS A proposed consensus document was created, using the Royal College of Surgeons of England undergraduate curriculum as a guide. This was circulated to an external advisory group for electronic suggestions of additional content not already described. Suggestions were discussed with the steering committee prior to inclusion within document. The resulting consensus document was presented to a face-face consensus meeting of medical students and foundation doctors at the Association of Surgeons in Training (ASiT) conference 2019 for live voting. Eighty percent agreement required to reach consensus. Any discussion of topics was transcribed to allow qualitative summary of discussion of those topics which did not reach consensus agreement. RESULTS Electronic suggestions yielded an extra 8 topics for inclusion into the final consensus document. A total of 52 people participated in the consensus session. The consensus discussed a total of 69 knowledge topics, practical skills and clinical examinations; of which 10 did not reach consensus agreement. Areas failing to reach consensus included knowledge topics in Ear Nose and Throat surgery, Vascular surgery and Neurosurgery as the consensus concluded that these topics were supplementary to core needs. CONCLUSION This paper presents a national consensus of the undergraduate surgical curriculum. This document should be used in conjunction with the RCS of England undergraduate curriculum to ensure students have an adequate surgical education.
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Hur HC, Green I, Modest AM, Milad M, Huang E, Ricciotti H. Needs assessment for electrosurgery training of residents and faculty in obstetrics and gynecology. JSLS 2016; 18:JSLS-D-13-00293. [PMID: 25392632 PMCID: PMC4154422 DOI: 10.4293/jsls.2014.00293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background and Objectives: Effective application of electrosurgical techniques requires knowledge of energy sources and electric circuits to produce desired tissue effects. A lack of electrosurgery knowledge may negatively affect patient outcomes and safety. Our objective was to survey obstetrics-gynecology trainees and faculty to assess their basic knowledge of electrosurgery concepts as a needs assessment for formal electrosurgery training. Methods: We performed an observational study with a sample of convenience at 2 academic hospitals (Beth Israel Deaconess Medical Center and Mount Auburn Hospital). Grand rounds dedicated to electrosurgery teaching were conducted at each department of obstetrics and gynecology, where a short electrosurgery multiple-choice examination was administered to attendees. Results: The face validity of the test content was obtained from a gynecologic electrosurgery specialist. Forty-four individuals completed the examination. Test scores were analyzed by level of training to investigate whether scores positively correlated with more advanced career stages. The median test score was 45.5% among all participants (interquartile range, 36.4%–54.5%). Senior residents scored the highest (median score, 54.5%), followed by attendings (median score, 45.5%), junior residents and fellows (median score in both groups, 36.4%), and medical students (median score, 27.3%). Conclusion: Although surgeons have used electrosurgery for nearly a century, it remains poorly understood by most obstetrician-gynecologists. Senior residents, attendings, junior residents, and medical students all show a general deficiency in electrosurgery comprehension. This study suggests that there is a need for formal electrosurgery training. A standardized electrosurgery curriculum with a workshop component demonstrating clinically useful concepts essential for safe surgical practice is advised.
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Affiliation(s)
- Hye-Chun Hur
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Isabel Green
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| | - Anna Merport Modest
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Magdy Milad
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Edwin Huang
- Department of Obstetrics and Gynecology, Mount Auburn Hospital, Cambridge, MA, USA
| | - Hope Ricciotti
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Mostaan LV, Poursadegh M, Pourhamze M, Roknabadi K, Shakeri MT. Overcoming Complications Through Pre-patient Surgical Training in Otolaryngology. Indian J Otolaryngol Head Neck Surg 2014; 66:4-7. [PMID: 24605292 DOI: 10.1007/s12070-012-0511-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 02/03/2012] [Indexed: 11/30/2022] Open
Abstract
Planning a balanced academic and practical surgical curriculum that is parallel to the constant innovations in surgical fields is the cornerstone of surgical education. Current training methods have coinciding benefits and drawbacks. In this study, we compare the efficacy of two learning models: pre-patient training outside the operating room versus step-by-step training on real patients in the operating room. Facial nerve preservation in superficial parotidectomy is the surgical model used in the study. Five otolaryngology residents in the third year of their residency participated in this study. They were divided into two groups: a treatment group which underwent a pre-patient training program by cadaver dissection and a control group which followed a step-by-step training model. At the end of the study, significant differences were apparent between two groups in the ability to find facial nerve trunk, microdissection of facial nerve branches, and the mean duration of total operating time. Pre-patient training programs outside the operating room provide surgical residents the opportunity to learn by trial and error without fear of complications.
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Affiliation(s)
- Leila Vazifeh Mostaan
- ENT Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Ebnesina St., Mashhad, Iran
| | - Mahdi Poursadegh
- ENT Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Ebnesina St., Mashhad, Iran
| | - Mojgan Pourhamze
- Vasee Hospital, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Koorush Roknabadi
- Amir-al-momenin Hospital, Bushehr University of Medical Sciences, Genaveh, Iran
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Abstract
Transition of a cancer patient from curative to palliative stage is one of the most difficult and challenging phases of cancer care both from patient and physician point of view. Most of the time the treating surgeons are expected to facilitate this transition but due to a number of reasons surgeons often fail to fulfill this crucial responsibility. This article highlights the various issues involved in the transition phase from a surgeons perspective.
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Affiliation(s)
- Sv Suryanarayana Deo
- Department of Surgical Oncology, Dr. BRA Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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