Consensus of Leaders in Plastic Surgery: Identifying Procedural Competencies for Canadian Plastic Surgery Residency Training Using a Modified Delphi Technique

Knox, Aaron; Shih, Jessica; Warren, Richard; Gilardino, Mirko S.; Anastakis, Dimitri J.

doi:10.1097/prs.0000000000004132

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…Program and individual data were anonymized throughout the analysis. As variation in procedure name exists between databases, case logs were coded according to the list of 8 Pediatric Core Procedural Competencies previously described by Knox et al 8 These core competencies included cleft lip repair, cleft palate repair, setback otoplasty, hemangioma/vascular anomaly excision, congenital melanocytic nevi excision, dermoid cyst excision, syndactyly release and reconstruction, and polydactyly reconstruction.…”

Section: Methodsmentioning

confidence: 99%

Resident Exposure and Involvement in Core Procedural Competencies within Pediatric Plastic Surgery

et al. 2022

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Introduction: The implementation of competency-based residency training in plastic surgery is underway. Key competencies in plastic surgery have been previously identified, however, within the domain of pediatrics, data suggest limited exposure throughout training for Canadian graduates. This study aims to identify the exposure and involvement of residents in core pediatric cases. Methods: We performed a retrospective, multicenter review of plastic surgery resident case logs (T-Res, POWER, New Innovations) across 10 Canadian, English-speaking training programs between 2004 and 2014. Case logs were coded according to the 8 core pediatric competencies previously identified by a modified Delphi technique. Results: A total of 3061 of 59 405 cases (5.2%) logged by 55 graduating residents were core pediatric procedures with an average of 55.6 ± 23.0 cases logged per resident. The top 3 most commonly logged procedures were cleft lip repair, cleft palate repair, and setback otoplasty. The number of cases per program varied widely with the most at 731 and least at 85 logged cases. Roles across procedures have wide variation and residents are most commonly identified as the assistant rather than surgeon or co-surgeon. Conclusion: These findings highlight variability both within and across residency programs with a paucity of exposure and involvement in pediatric plastic surgery cases. This may present a conflict between current recommendations for residency-specific procedural competencies and true clinical exposure. Further curriculum development and simulation may be of benefit.

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Section: Methodsmentioning

confidence: 99%

Resident Exposure and Involvement in Core Procedural Competencies within Pediatric Plastic Surgery

et al. 2022

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“…43 Similarly, their counterparts in Canada and the United Kingdom, demonstrated national efforts at standardization of competency training guided by case logs and educational theories. 34,[44][45][46][47] Many experts call for the development of such projects through assessment of case logs and in-service examinations to identify areas of deficiencies. 10,38,39,45,48 The argument for competency-based residency is beyond the scope of this work, with evident international adoption despite arguments against it.…”

Section: Creating Interventions Adapted To Competency Acquisition Sho...mentioning

confidence: 99%

“…This includes aligning the goals to the essential competencies recognized by experts. 1,13,15,23,34 The evaluation process should also demonstrate competency at different levels of learning to guide the training process. 21 To that end, this review aimed to appraise available interventions for competency assessment and to provide guidance and improve the transition toward competency-based training in plastic surgery.…”

Section: Creating Interventions Adapted To Competency Acquisition Sho...mentioning

confidence: 99%

Toward Competency-Based Training: To What Extent Are We Competency-Based?

Al-Halabi

Bilgiç

Vassiliou

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Background: Time-based training models in plastic surgery vary in exposure, resulting in low confidence levels among graduates. The evolution of postgraduate medical education into a competency-based model to address these issues requires an understanding of interventions described in the plastic surgery literature to identify gaps and guide creation of assessments to demonstrate competence. Methods: A systematic search of the MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, PubMed, and Cochrane databases from inception until December of 2017 was conducted using search terms and synonyms of educational interventions reported in plastic surgery. Full texts were retrieved following filtering and data extracted were related to intervention design and execution, involvement of competency assessment, and educational objectives and alignment to Accreditation Council for Graduate Medical Education competencies and Royal College of Physicians and Surgeons of Canada Canadian Medical Education Directives for Specialists roles. Study quality was assessed using Kirkpatrick's levels of learning evaluation, validity evidence, and the Medical Education Research Study Quality Instrument score. Results: Of the initial 4307 results, only 36 interventions met the inclusion criteria. Almost all interventions aligned to medical knowledge and patient care Accreditation Council for Graduate Medical Education competencies. One-fifth of the interventions involved no assessment of competency, whereas most displayed assessment at the level of design as opposed to outcomes. Quality assessment revealed low levels of learning evaluation and evidence of validity; the average Medical Education Research Study Quality Instrument score was 10.9 of 18. Conclusion: A systematic review of educational literature in plastic surgery was conducted to assess the quality of reported educational interventions, and to help guide creating tools that ensure competency acquirement among trainees.

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“…Of particular interest is the bilobe flap for nasal reconstruction, which is a commonly performed local facial flap and is considered a core procedure by experts in the field. 6,20 However, independently performing local facial flap reconstruction can be a challenging task for trainees due to the inherent geometric complexity of certain designs and lack of experience. 6 Further exacerbating this issue is the fact that many institutions saw a significant decrease in elective cases during the early stages of the COVID-19 pandemic.…”

mentioning

confidence: 99%

“…Performing local facial reconstruction is critical for resident training and can constitute as a key indicator case according to the Accreditation Council for Graduate Medical Education. Of particular interest is the bilobe flap for nasal reconstruction, which is a commonly performed local facial flap and is considered a core procedure by experts in the field 6,20 . However, independently performing local facial flap reconstruction can be a challenging task for trainees due to the inherent geometric complexity of certain designs and lack of experience 6 .…”

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confidence: 99%

Comparing Feedback Techniques in Bilobe Flap Simulation Using 3D‐Printed Facial Models

Shay,

Zaniletti,

Coffman

et al. 2023

OTO Open

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ObjectiveTo compare live versus delayed feedback on trainee performance of bilobe flaps using 3‐dimensional (3D)‐printed facial simulators and determine whether these effects are sustained on repeat performance.Study DesignCohort study.SettingUniversity of Arkansas for Medical Sciences.Methods3D‐printed facial models with a nasal ala defect were provided to 18 subjects. Subjects were stratified and randomized based on their training level into 1 of 3 groups corresponding to live feedback (Group 1), delayed feedback (Group 2), and no feedback (Group 3). Subjects performed a bilobe flap following a structured lecture. Four weeks later, subjects independently repeated the exercise on the contralateral ala. Likert surveys were used to assess subjective parameters. Objective grading was performed by a plastic surgeon, which included a point system and score for the overall appearance.ResultsFollowing exercise 1, Group 1 reported a significant improvement in knowledge (P < .001), which was sustained after exercise 2 (P < .001); Group 2 reported a significant improvement after exercise 1 (P = .03) but was not sustained (P = .435). After the second exercise, Group 1 and Group 2 improved their confidence in bilobed repair (P = .001 and P = .003, respectively), but this was greater for Group 1. Group 1 showed a significant improvement in their design time following exercise 2 (P = .007). There were no significant differences between groups on total time for repair, total score, and appearance.Conclusion3D‐printed models are valuable in teaching the bilobe flap for nasal defects, with live feedback providing the greatest level of improvement in self‐reported knowledge and confidence.

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Consensus of Leaders in Plastic Surgery: Identifying Procedural Competencies for Canadian Plastic Surgery Residency Training Using a Modified Delphi Technique

Cited by 11 publications

References 25 publications

Resident Exposure and Involvement in Core Procedural Competencies within Pediatric Plastic Surgery

Resident Exposure and Involvement in Core Procedural Competencies within Pediatric Plastic Surgery

Toward Competency-Based Training: To What Extent Are We Competency-Based?

Comparing Feedback Techniques in Bilobe Flap Simulation Using 3D‐Printed Facial Models

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