Rural surgery

Borgstrom, David C.; Deveney, Karen E.; Hughes, Dorothy; Rossi, Isolina R.; Rossi, Matthew B.; Lehman, Randy; LeMaster, S; Puls, Mark

doi:10.1016/j.cpsurg.2022.101173

Cited by 5 publications

(2 citation statements)

References 66 publications

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“…However, smaller hospitals provide invaluable support on the path to becoming a competent surgeon. They offer the opportunity to take on a higher degree of responsibility and develop greater autonomy at an earlier stage of training [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

There is a need for a paradigm shift in laparoscopic surgical training: results of a nationwide survey among teaching hospitals in Switzerland

Wczysla,

Sparn,

Schmied

et al. 2024

BMC Med Educ

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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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Section: Discussionmentioning

confidence: 99%

There is a need for a paradigm shift in laparoscopic surgical training: results of a nationwide survey among teaching hospitals in Switzerland

Wczysla,

Sparn,

Schmied

et al. 2024

BMC Med Educ

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“…29,30 Orthopedic surgeons can be economic drivers for local hospitals. 31,32 Hoskins et al 31 demonstrated the significant positive impact that surgical services have on the bottom line of critical access hospitals, and Weichel 25 noted that having a full-time orthopedic surgeon significantly impact the bottom line of rural hospitals. Recruiting more orthopedic surgeons to rural Kansas would seem to be critical in maintaining overall access to care for people living in those areas.…”

Section: Discussionmentioning

confidence: 99%

Physician Workforce in Kansas: Where are the Orthopedic Surgeons?

Hughes,

Reese,

Templeton

2024

kjm

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Introduction. Rural patients have greater need but less access to orthopedic surgical care than their urban counterparts. Previous studies have investigated rural surgical care, but this is the first to assess the Kansas orthopedic surgery workforce to identify changes over time and rurality and inform thinking about future workforce composition. Methods. The authors analyzed 2009 and 2019 AMA MasterFile and Area Health Resource File (AHRF) data. Using frequencies, percentages, and calculations of orthopedic surgeons per capita, we assessed workforce changes by rurality (Rural Urban Continuum Codes). Results. The dataset included 307 orthopedic surgeons; 197 were in both 2009 and 2019. Of these, 165 were in active practice in 2009 and 244 in 2019, an increase of 79 (47.9%). Kansas had smaller proportions of surgeons in rural (non-metro) versus urban (metro) counties in both years. Orthopedic surgeons per capita grew throughout the state, but the increase was smaller in rural counties. There were 11 women orthopedic surgeons in both years, 3.6% of the total 307. Among the 197 surgeons in both years, four (2.0%) were women. No women orthopedic surgeons were in non-metro counties either year. Conclusions. Although the Kansas orthopedic surgery workforce grew from 2009 to 2019, rural Kansas remains a surgery desert based on orthopedic surgeons per capita. Further studies could determine whether this trend is similar to that in other rural states and how to attract orthopedic surgeons to rural practice.

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