Defining operative experience targets in surgical training: A systematic review

Toale, Conor; O’Byrne, Aisling; Morris, Marie; Kavanagh, Dara

doi:10.1016/j.surg.2022.07.015

Cited by 7 publications

(5 citation statements)

References 62 publications

(90 reference statements)

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“…Surgical training poses increasing demands for residents to gain experience in broad techniques, with mastery expected in open, laparoscopic, robotic, endoscopic, and endovascular techniques. 1 In vascular surgery, endovascular techniques have supplanted open approaches in many areas. 2 , 3 Similarly, the rise of integrated vascular surgery residency programs may affect vascular surgical training for general surgery trainees, particularly as such programs grow in prevalence and maturity.…”

Section: Introductionmentioning

confidence: 99%

Vascular Anastomoses and Dissection: A Six-Part Simulation Curriculum for Surgical Residents

Brian,

Rodriguez,

Rapp

et al. 2024

MedEdPORTAL

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Introduction As surgical technologies grow, so too do demands on surgical trainees to master increasing numbers of skill sets. With the rise of endovascular surgery, trainees have fewer opportunities to practice open vascular techniques in the operating room. Simulation can bridge this gap. However, existing published open vascular simulation curricula are basic or based on expensive models. Methods We iteratively developed an open vascular skills curriculum for second-year surgery residents comprising six 2-hour sessions. We refined the curriculum based on feedback from learners and faculty. The curriculum required skilled facilitators, vascular instruments, and tissue models. We evaluated the latest iteration with a survey and by assessing participants’ technical skills using the Objective Structured Assessment of Technical Skills (OSATS) form. Results Over the past 10 years, 101 residents have participated in the curriculum. Nine of 13 residents who participated in the latest curricular iteration completed the survey. All respondents rated the sessions as excellent and strongly agreed that they had improved their abilities to perform anastomoses with tissue and prosthetic. Facilitators completed 18 OSATS forms for residents in the fifth and sixth sessions of the latest iteration. Residents scored well overall, with a median 26.5 (interquartile range: 24–29) out of a possible score of 35, with highest scores on knowledge of instruments. Discussion This simulation-based curriculum facilitates open vascular surgical skill acquisition among surgery residents. The curriculum allows residents to acquire critical vascular skills that are challenging to learn in an increasingly demanding operative setting.

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Section: Introductionmentioning

confidence: 99%

Vascular Anastomoses and Dissection: A Six-Part Simulation Curriculum for Surgical Residents

Brian,

Rodriguez,

Rapp

et al. 2024

MedEdPORTAL

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“…In the United States, general surgery residents must complete a minimum of 850 cases - at least 175 of which must be laparoscopic - in order to be considered safe and competent surgeons and thereby graduate from a training program [ 25 ]. Without extending the length of surgical training, the addition of robotic surgery to surgical training will significantly reduce the number of laparoscopic and/or open cases completed by trainees, especially given that the number of cases required to achieve competence on the robotic platform has been estimated to be around 50 cases in the hands of already very experienced laparoscopic surgeons (though they vary widely) and may be significantly higher for trainees [ [26] , [27] , [28] , [29] , [30] , [31] , [32] ].…”

mentioning

confidence: 99%

Is the robotic revolution stunting surgical skills?

Lazar,

Ferzli

2024

Surgery Open Science

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“…4 The implementation of such programs requires robust methods of summative assessment. Operative competence of graduating trainees is a core requirement in the surgical specialties and is commonly assessed through a combination of workplace-based in-theater assessments (eg, Procedure-Based Assessments in the United Kingdom and Ireland 5 and Entrustable Professional Activity assessments in the USA 6,7 ), minimum operative experience targets, 8 and subjective global trainer evaluations.…”

mentioning

confidence: 99%

“…10 Furthermore, the assessment validity of operative experience targets is highly questionable. 8,[11][12][13] Simulation-based assessment may represent a more objective and standardizable approach to the assessment of operative competence. The implementation of the Colorectal Objective Structured Assessment of Technical Skill into the American Board of Colon and Rectal Surgery (ABCRS) certification process 14 and the similar development of the General Surgery Objective Structured Assessment of Technical Skill (GOSATS) examination 15 demonstrate how simulation-based assessment could be used to objectively inform decisions regarding trainee progression and certification.…”

mentioning

confidence: 99%

“…Concerns exist regarding the validity and acceptability of these currently utilized assessments, in particular relating to the perceived subjectivity of workplace-based assessments, 9 the opportunistic nature in which they are used by trainees, 9,10 and the accuracy of trainee-recorded data 10 . Furthermore, the assessment validity of operative experience targets is highly questionable 8,11–13 . Simulation-based assessment may represent a more objective and standardizable approach to the assessment of operative competence.…”

mentioning

confidence: 99%

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Generating a Prioritised List of Operative Procedures for Simulation-Based Assessment of General Surgery Trainees through Consensus

Toale,

Morris,

Konge

et al. 2023

Annals of Surgery

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Objective: to develop appropriate content for high-stakes simulation-based assessments of operative competence in general surgery training through consensus. Summary Background Data: Valid methods of summative operative competence assessment are required by competency-based training programmes in surgery. Method: An online Delphi consensus study was conducted. Procedures were derived from the competency expectations outlined by the Joint Commission on Surgical Training (JCST) curriculum 2021, and subsequent brainstorming. Procedures were rated according to their perceived importance, perceived procedural risk, how frequently they are performed, and feasibility, by a purposive sample of thirty surgical trainers and a five-person steering group. A modified Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES NAF) was applied to generated data in order to produce ranked procedural lists, which were returned to participants for re-prioritization. Results: Prioritised lists were generated for simulation-based operative competence assessments at two key stages of training; end of ‘phase 2’ prior to development of a sub-specialty interest, and end of ‘phase 3’ i.e. end-of-training certification. A total of 21 and 16 procedures were deemed suitable for assessments at each of these stages respectively. Conclusions: This study describes a national needs assessment approach to content generation for simulation-based assessments of operative competence in general surgery using Delphi consensus methodology. The prioritised procedural lists generated by this study can be used to further develop operative skill assessments for use in high-stakes scenarios such as trainee progression, entrustment and end-of-training certification prior to subsequent validity testing.

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Defining operative experience targets in surgical training: A systematic review

Cited by 7 publications

References 62 publications

Vascular Anastomoses and Dissection: A Six-Part Simulation Curriculum for Surgical Residents

Vascular Anastomoses and Dissection: A Six-Part Simulation Curriculum for Surgical Residents

Is the robotic revolution stunting surgical skills?

Generating a Prioritised List of Operative Procedures for Simulation-Based Assessment of General Surgery Trainees through Consensus

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