Comparison of Canadian and Swiss Surgical Training Curricula: Moving on Toward Competency-Based Surgical Education

Hoffmann, Henry; Oertli, Daniel; Mechera, Robert; Dell-Kuster, Salome; Rosenthal, Rachel; Reznick, Richard K.; MacDonald, Hugh

doi:10.1016/j.jsurg.2016.07.013

Cited by 14 publications

(7 citation statements)

References 41 publications

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“…We can only estimate that this would also help to increase the relevance of surgical education for financing such programs by hospital administrations. In contrast, structured curricula reduce the flexibility and individualized training provided by the trainers; also, structured curricula are vulnerable to a lack of personnel, which will be a growing concern due to the decreasing number of medical professionals in the following years [4], [16].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there is no evidence whether the number requested in the logbook reproduces the skills acquired by the resident [3]. The only study comparing structured and rather unstructured surgical education programs analyzed the Canadian and Swiss educational programs and even stated that providing a more structured surgical program may be advantageous in providing optimal quality of surgical education [4]. However, the authors only compared one teaching hospital of each country in their study [4].…”

Section: Surgical Training Programsmentioning

confidence: 99%

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Evidence in surgical training – a review

Fritz

Stachel

Braun

2019

Innovative Surgical Sciences

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The first residency programs for surgical training were introduced in Germany in the late 1880s and adopted in 1889 by William Halsted in the United States [Cameron JL. William Stewart Halsted. Our surgical heritage. Ann Surg 1997;225:445–58.]. Since then, surgical education has evolved from a sheer volume of exposure to structured curricula, and at the moment, due to work time restrictions, surgical education is discussed on an international level. The reported effect of limited working hours on operative case volume has been variable [McKendy KM, Watanabe Y, Lee L, Bilgic E, Enani G, Feldman LS, et al. Perioperative feedback in surgical training: a systematic review. Am J Surg 2017;214:117–26.]. Experienced surgeons fear that residents do not have sufficient exposure to standard procedures. This may reduce the residents’ responsibility for the treatment of the patient and even lead to a reduced autonomy at the end of the residency. Surgical education does not only require learning the technical skills but also human factors as well as interdisciplinary and interprofessional handling. When analyzing international surgical curricula, major differences even between countries of the European Union with more or less strict curricula can be found. Thus far, there is no study that analyzes the educational program of different countries, so there is no evidence which educational system is superior. There is also little evidence to distinguish the good from the average surgeon or the junior surgeons’ progress during his residency training. Although some evaluation tools are already available, the lack of resources of most teaching hospitals often results in not using these tools as long it is not mandatory by a governmental program. Because of decreased working hours, increasing hospital costs, and increasing jurisdictional restrictions, teaching hospitals and teachers will have to change their sentiments and focus on their way of surgical education before governmental regulations will emerge leading to more regulation in surgical education. Some learning tools such as simulation, electronic learning, augmented reality, or virtual reality for a timely, sufficient and up to date surgical education. However, research and evidence for existing and novel learning tools will have to increase in the next years to allow surgical education for the future generation of surgeons around the world.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Training Programsmentioning

confidence: 99%

Evidence in surgical training – a review

Fritz

Stachel

Braun

2019

Innovative Surgical Sciences

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“…ÄiW in Kanada empfanden das Weiterbildungskonzept als sehr strukturiert. Dort zeigte sich, dass dennoch nur durchschnittlich 8,8 % der wöchentlichen Arbeitszeit in die Weiterbildung investiert wurden [ 8 ]. Diese findet in Kanada hauptsächlich an den Universitätskliniken statt.…”

Section: Hintergrundunclassified

“…In der Schweiz wird zum Teil nur der geringe Anteil von 1,7 % der wöchentlichen Arbeitszeit für die Weiterbildung aufgewendet [ 8 ]. Diese wird dort als eher unstrukturiert empfunden [ 10 ].…”

Section: Hintergrundunclassified

Einsatz chirurgischer Simulatoren in der Weiterbildung – eine deutschlandweite Analyse

Brunner

Kröplin

Meyer

et al. 2021

Chirurg

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Zusammenfassung Hintergrund Die chirurgische Facharztweiterbildung erfordert neben dem Erlernen theoretischen Wissens ebenfalls den Erwerb praktisch-chirurgischer Kompetenzen. Eine Alternative zur Aus- und Weiterbildung am Patienten stellen simulationsbasierte Lehrkonzepte dar. Ziel der vorliegenden Studie ist die Analyse der Verteilung und des Einsatzes chirurgischer Simulatoren in deutschen Kliniken. Methoden Die Datenanalyse erfolgte auf Basis eines individuellen Onlinefragebogens mit insgesamt 19 standardisierten Fragen. Dieser wurde über die E‑Mail-Verteiler der deutschen chirurgischen Fachgesellschaften an die leitenden chirurgischen Klinikärzte versendet. Ergebnisse Insgesamt 267 vollständige Antwortdatensätze wurden analysiert (Rücklaufquote 12,0 %). 84,0 % der Teilnehmer gaben ihre Tätigkeit an einem Lehrkrankenhaus an. Zum Zeitpunkt der Untersuchung waren 143 chirurgische Simulatoren an 35,0 % der in die Auswertung eingeschlossenen Kliniken vorhanden. Regional zeigten sich deutliche Unterschiede zwischen den einzelnen Bundesländern. 21,1 % der Teilnehmer, an deren Klinik kein Simulator zur Verfügung steht, planten eine Neubeschaffung. Studierende (41,1 %) und Ärzte in Weiterbildung (ÄiW, 32,5 %) nutzten das Simulationstraining am häufigsten. Eine Integration in die chirurgische Weiterbildung bestand zu 81,8 % nicht. 94,0 % der beteiligten Kliniken zeigten Interesse an einer zukünftigen Integration in die chirurgische Facharztweiterbildung. Schlussfolgerung Die vorliegenden Ergebnisse bestätigen die besondere Bedeutung des simulationsbasierten Trainings für die chirurgische Weiterbildung an deutschen Kliniken. Gleichzeitig bestehen deutliche Informationsdefizite über das Nutzungsverhalten sowie eine defizitär empfundene Integration des Simulationstrainings in die chirurgische Weiterbildung.

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“…Thus, there is now an urgent need to develop methods to ensure trainees' competence despite these losses of teaching and clinical time. Pressure to maintain efficiency of care, changes to patient safety requirements, and the recent restrictions of resident duty hours have driven the transition to CBME 456…”

Section: Introductionmentioning

confidence: 99%

Implementing Competency-Based Medical Education in Internal Medicine Residency Training Program: the Process and Impact on Residents' Satisfaction

2019

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Background Graduate medical education is shifting from the traditional apprenticeship model to a competency-driven model. Here we describe the design and implementation of competency-based medical education (CBME) in an internal medicine residency program, and report satisfaction survey results. Methods We redesigned the residency curriculum as CBME to be resident-centred, systematic, focused on general internal medicine, to provide experience in various care setting, and work-based assessment. In the second year of this CBME transition, we surveyed residents' overall satisfaction using 5-point Likert scale. Feedback on their training program was also analysed. Results The overall satisfaction score was 3.24 and thirteen residents (61.9%) answered that the preceptor's practical training in an educational atmosphere and improvement through training were the merits of the training program. However, residents complained about the working condition such as work overload. Conclusion With the CBME implementation, most residents expressed satisfaction with the hospital's educational environment but they suffered from overwork. Further efforts to improve the educational program and environment are warranted.

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Comparison of Canadian and Swiss Surgical Training Curricula: Moving on Toward Competency-Based Surgical Education

Abstract: Providing more structured surgical training elements may be advantageous in providing optimal-quality surgical education in an era of work-hour restrictions.

Cited by 14 publications

References 41 publications

Evidence in surgical training – a review

Evidence in surgical training – a review

Einsatz chirurgischer Simulatoren in der Weiterbildung – eine deutschlandweite Analyse

Implementing Competency-Based Medical Education in Internal Medicine Residency Training Program: the Process and Impact on Residents' Satisfaction

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