Achieving Consensus to Define Curricular Content for Simulation Based Education in Vascular Surgery: A Europe Wide Needs Assessment Initiative

Abstract

WHAT THIS PAPER ADDS A three round Delphi questionnaire process has led to a European consensus document focusing on technical procedures for simulation based education in vascular surgery and has proposed a roadmap to plan and develop future simulation based training programs for vascular surgeons across Europe. Objective: To gather consensus among European educators about technical procedures that should be included in a future simulation based curriculum in vascular surgery. Methods: A three round modified Delphi survey was initiated among 189 key opinion leaders (KOL) from 34 countries across Europe who were identified according to their positions in the European Society for Vascular Surgery, the European Journal of Vascular and Endovascular Surgery, and Union Européenne des Médecins Spécialistes Section and Board of Vascular Surgery. The first round was a brainstorming phase to identify technical procedures that a newly qualified vascular surgeon should be able to perform. The answers were analysed qualitatively. The second round investigated how often the identified procedures are performed, the number of vascular surgeons that should be able to perform these procedures, whether the procedures pose a risk to the patients, and whether simulation based education (SBE) is feasible. In the third round, elimination and re-ranking of procedures were performed. Only procedures that gained more than 70% support were included. An international steering group consisting of open and endovascular surgeons and medical educators governed the process. Results: Response rates in the three rounds were 75% (142/189), 89% (126/142), and 85% (107/126), respectively. In the final prioritised list of 30 technical procedures for SBE, the top five procedures focus on basic open vascular skills, basic endovascular skills, vascular imaging interpretation, femoral endarterectomy, and open peripheral bypass. Twenty-six procedures were eliminated, including peripheral pressure measurement, wound management, open management of complications, major amputations, and highly advanced endovascular skills. Conclusion: The prioritised list of technical procedures from this ESVS supported project could be used to guide planning and development of future SBE programs to meet the needs of vascular surgeons across Europe.

Learn EVAR sizing from scratch: The results of a one-day intensive course in EVAR sizing and stent graft selection for vascular trainees

“…The current global shift in medical education towards a competency-based approach has been widely adopted in the vascular community. 14,16,17 There is an increasing amount of evidence for simulation-based training of both open and especially endovascular skills and patient-specific simulation in EVAR has shown unequivocal and favorable results. 7,9,17,18 Most studies investigating simulation-based EVAR training focus on technical skills and graft implantation and overlook one important issue for a successful implementation, namely sizing and graft selection.…”

“…6,7,13 Key opinion leaders from 34 countries across Europe have recently gained consensus on the curricular content for simulationbased training in vascular surgery in which EVAR and "planning and sizing" were ranked as the sixth most important skill to learn during vascular surgical training. 14 How vascular trainees can achieve sufficient skills in EVAR sizing and graft selection following a predefined curriculum and workshop format is sparsely explored although essential for successful EVAR implantation.…”

We Want to OPERATE!

“…Despite its beneficial impact on surgical expertise in daily practice, simulation has not been widely accepted in health care. 4 As stated in the Europe wide needs assessment in vascular surgery, there is an urgent need for open AAA simulation based training. 4 The article by Nayahangan et al evaluates development of a simulation based assessment tool, OPERATE (Open aortic aneurysm Repair Assessment of Technical Expertise) to assess technical expertise in open AAA repair and has gathered validity evidence according to Messick's validity framework.…”

“…4 As stated in the Europe wide needs assessment in vascular surgery, there is an urgent need for open AAA simulation based training. 4 The article by Nayahangan et al evaluates development of a simulation based assessment tool, OPERATE (Open aortic aneurysm Repair Assessment of Technical Expertise) to assess technical expertise in open AAA repair and has gathered validity evidence according to Messick's validity framework. 2 Three highly experienced AAA surgeons and one educationalist developed the tool inspired by other instruments (OSATS, ICEPS, and PBA).…”

The ESVS Academy is Growing…

“…Education and science go hand in hand, which is also reflected in a recent publication in the European Journal of Vascular and Endovascular Surgery including several ESVS Academy members and the UEMS. 2 Herein, the first European Needs Assessment within Vascular Surgery has been created and described in an attempt to stimulate and adapt simulation based education in daily practice. Finally, during the scientific programme in Hamburg, the category education has returned, allowing educational researchers in the vascular field to submit their work and present at the annual meeting.…”