Assessing the Effectiveness of Surgical Skills Laboratories

Varban, Oliver A.; Ardestani, Ali; Peyré, Sarah E.; Smink, Douglas S.

doi:10.1097/sih.0b013e318276306e

Cited by 10 publications

(9 citation statements)

References 23 publications

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“…This finding agrees with previously published work on the effect of PGY on outcomes [4], and may represent an opportunity for better educational objectives, improved intraoperative teaching and supervision, and potentially surgical simulation [27,28]. Recent work has shown that the greatest benefit for surgical simulation and skills laboratory training is derived in the junior years of training [29] and that simulation-models may be an effective tool to improve intra-operative decision-making [30]. These findings must be confirmed prospectively and represent an area of future interest and study.…”

Section: Discussionsupporting

confidence: 90%

The impact of surgical resident participation in breast reduction surgery – Outcome analysis from the 2005–2011 ACS-NSQIP datasets

Fischer

Wes

Kovach

2014

Journal of Plastic Surgery and Hand Surgery

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Breast reduction surgery is a common and effective surgical technique for treating symptomatic macromastia. There is limited data on the impact of resident involvement on outcomes. This study uses the ACS-NSQIP datasets to assess the impact of surgical resident participation in breast reduction surgery. This study reviewed the 2005-2011 ACS-NSQIP databases identifying primary encounters for reduction mammaplasty with CPT code "19318". It characterised surgical complications into three groups: any, major, and wound complications. Propensity scoring and matched analysis were used to account for non-randomised assignment. In total, 4328 patients underwent reduction mammoplasty during the study period. Resident participation was identified in 56.3% of cases. Logistic regression analysis determined the following factors independently associated with resident participation: class II obesity (OR = 0.73, p < 0.001), class III obesity (OR = 0.68, p < 0.001), dyspnea (OR = 1.59, p = 0.04), and ASA physical status of 3 (OR = 1.51, p < 0.001). A propensity score was assigned based on probability of resident involvement and matched cohorts were created and analyzed. A logistic regression analysis of the matched cohort data revealed that resident participation was independently associated with major surgical complications (OR = 2.18, p = 0.008). Prolonged operative (>2 SD) was associated with any (OR = 3.3, p = 0.039) and wound (OR = 10.2, p = 0.028) complications. A separate logistic regression analysis of the unmatched cohort using stratified PGY experience demonstrated that junior PGY was most highly associated with any (OR = 1.93, p = 0.013), major (OR = 2.4, p = 0.034), and wound (OR = 1.9, p = 0.04) complications. Resident participation was associated with added risk of surgical morbidity, and PGY experience was inversely related to risk of surgical complications in breast reduction surgery.

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Section: Discussionsupporting

confidence: 90%

The impact of surgical resident participation in breast reduction surgery – Outcome analysis from the 2005–2011 ACS-NSQIP datasets

Fischer

Wes

Kovach

2014

Journal of Plastic Surgery and Hand Surgery

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“…Responding to the evolving challenges in the surgical training, the Residency Review Committee (RRC) for graduate medical education in the USA requires since 2008 that all residency training programs have to provide surgical residents with access to surgical skills laboratory. Moreover, these facilities must address acquisition and maintenance of skills with a competency-based method of evaluation [36]. Furthermore, the ACS and APDS developed a national skill curriculum in 2007 that is Web-based, is free of charge, and uses proven methods for training, with an emphasis on distributed, deliberate, and structured practice using performance-based end points [37].…”

Section: Skill Acquisition and Deliberate Practicementioning

confidence: 99%

“…Furthermore, the ACS and APDS developed a national skill curriculum in 2007 that is Web-based, is free of charge, and uses proven methods for training, with an emphasis on distributed, deliberate, and structured practice using performance-based end points [37]. The ACS and the society of American gastrointestinal endoscopic surgeons launched the Fundamentals of Laparoscopic Surgery (FLS) which represents the first validated simulation module to be standardized and is now required for surgeons seeking board certification in general surgery in the USA [36,38]. In a recent survey distributed to all residency programs in the USA, 99% of the responders (81 Programs) to the survey had a skill or simulation laboratory [36].…”

Section: Skill Acquisition and Deliberate Practicementioning

confidence: 99%

“…The ACS and the society of American gastrointestinal endoscopic surgeons launched the Fundamentals of Laparoscopic Surgery (FLS) which represents the first validated simulation module to be standardized and is now required for surgeons seeking board certification in general surgery in the USA [36,38]. In a recent survey distributed to all residency programs in the USA, 99% of the responders (81 Programs) to the survey had a skill or simulation laboratory [36].…”

Section: Skill Acquisition and Deliberate Practicementioning

confidence: 99%

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Objective Assessment of Surgical Skills in a 2-Day Visceral Anastomosis Techniques Course hold in the Annual Congress of the German Surgical Society (DGCH)

et al. 2016

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Introduction: Simulation skill Laboratories are being increasingly marketed from different institutions and are widely accepted in Europe and the USA. Furthermore, residency training programs in the USA are incorporating such Laboratories into their residency curricula after being mandated by the American College of Surgery (ACS) in 2008 and are using them in the last few years to evaluate the competency of their surgical residents. Unlike to North America, the literature to date has shown a little, when none about simulation skill labors/Curricula despite their existence in private institutes or few residency training programs in Europe. We still rely mainly on our traditional training methods and surgical simulators are still predominantly aimed at attracting attention at surgical equipment exhibits. One of the well-known simulation skill Laboratories in Germany is hold yearly since 2005 in the annual German surgical meetings (DGCH). This Skill Laboratory is subdivided into different courses over 4 days with different modules in station-setting which includes common trunk surgical skills, visceral Laparoscopic techniques, and conventional visceral anastomosis techniques as well as courses in vascular and orthopedic surgery. A valid und reliable objective assessment tool was developed in Canada and currently used widely by residency training programs in the USA and Canada to evaluate the efficacy of technical skill development outside the operating room in a bench setting. This tool is called, the Objective Structured Assessment of Technical Skill (OSATS). The aim of our study is to demonstrate the improvement of surgical skills through the participation in a selected training module using a validated international assessment tool (OSATS). Materials and Methods: The visceral anastomosis course which includes five training modules on animal models and takes place over two days was selected for evaluation. Performance of the participants in one module (end-to-end Bowel anastomosis) was measured by qualified surgeons using a task specific Checklist at the beginning and at the end of the course with instructor to participant ratio 1 to 10. The improvement in OSATS scores pre-post the course was assessed using paired T-Test. Participants were asked to perform a baseline bowel anastomosis independent of the course and their scores was analyzed as a possible correlation factor with final OSATS scores. Demographic data of the Participants as well as subjective evaluation forms were collected. Results: A total of 38 surgical residents completed the 2-day visceral anastomosis course. The mean age was 34 ± 6 years. Fifty-eight Percent were males. Most of the participants were in their 4th and 5th years of residency training. 66% reported performing ≤ 10 Bowel Anastomosis since the beginning of their surgical training. Eight participants (21%) were able to perform an end-to-end Bowel Anastomosis independent of the course and scored a mean of 15 ± 3 in OSATS. OSATS scores improved significantly after completing the course (p...

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“…Since the importance of simulation training for the acquisition of surgical skills in a safe environment has become more apparent, the ACGME has stated that surgical residency program resources must include simulation and skills laboratories at teaching hospitals, and they must be used in conjunction with a competency-based method of evaluation (7). A 2013 national survey of surgical skills laboratories conducted in the US demonstrated that 99% of surgical residency programs had a simulation laboratory, 63% of the programs had organized simulation curriculum, and 77% of them utilized the mandated scheduled time for surgical training in the laboratory (9). Successful simulation centers can complement appropriate curriculum M A N U S C R I P T…”

Section: Program Directorsmentioning

confidence: 99%

Where do we start? The first survey of surgical residency education in Japan

Kurashima

Watanabe

Ebihara

et al. 2016

The American Journal of Surgery

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Background: Currently, Japan does not have a national standardized program for surgical residency. Therefore, surgical education information and strategies are not shared among teaching hospitals. This was the first study aiming to clarify the current situation of surgical residency in Japan. Methods:A questionnaire survey investigating the present situation of surgical residency was sent to the 76 teaching hospitals in Hokkaido Prefecture, Japan. Results:The response rate was 64.5%. Data from the 36 hospitals with active residency programs were analyzed. Most of the program directors (79.4%) were in charge of educational work for less than 5 hours per week. While half of the hospitals had skills laboratories or simulation centers, only two used them routinely for their residency program. Half of the hospitals evaluated the residents' competency and the quality of their educational programs. this system is that information and surgical education strategies are not being shared among teaching hospitals. The purpose of this study was to conduct the first survey aiming to clarify the current situation of surgical residency and the problems related to surgical education in Japan. Conclusions Methods Survey developmentThe questionnaire items were created after three roundtable discussions among the authors, each of whom were senior staff surgeons and in charge of teaching medical students and surgical residents at Hokkaido University Hospital. (Table 1). SubjectsThe questionnaires were sent by mail to the persons responsible for the surgical residency programs at the 76 teaching hospitals with university-based or community-based programs in Hokkaido prefecture. Hokkaido prefecture is the northernmost island in Japan, with a population of 5.4 million and the area of 32,210 square mile. The subjects of the residency programs of these 76 hospitals included general surgery, gastroenterological surgery, thoracic surgery and cardiovascular surgery, and each hospital had capacity for one to five postgraduate year (PGY) surgical residents.

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Assessing the Effectiveness of Surgical Skills Laboratories

Cited by 10 publications

References 23 publications

The impact of surgical resident participation in breast reduction surgery – Outcome analysis from the 2005–2011 ACS-NSQIP datasets

The impact of surgical resident participation in breast reduction surgery – Outcome analysis from the 2005–2011 ACS-NSQIP datasets

Objective Assessment of Surgical Skills in a 2-Day Visceral Anastomosis Techniques Course hold in the Annual Congress of the German Surgical Society (DGCH)

Where do we start? The first survey of surgical residency education in Japan

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