Gynaecological Endoscopic Surgical Education and Assessment. A diploma programme in gynaecological endoscopic surgery

Abstract

In recent years, training and education in endoscopic surgery has been critically reviewed. Clinicians, both surgeons as gynaecologist who perform endoscopic surgery without proper training of the specific psychomotor skills, are at higher risk to increased patient morbidity and mortality. Although the apprentice-tutor model has long been a successful approach for training of surgeons, recently, clinicians have recognised that endoscopic surgery requires an important training phase outside the operating theatre. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA) recognises the necessity of this structured approach and implements two separated stages in its learning strategy. In the first stage, a skill certificate on theoretical knowledge and specific practical psychomotor skills is acquired through a high-stake exam; in the second stage, a clinical programme is completed to achieve surgical competence and receive the corresponding diploma. Three diplomas can be awarded: (a) the Bachelor in Endoscopy, (b) the Minimally Invasive Gynaecological Surgeon (MIGS) and (c) the Master level. The Master level is sub-divided into two separate diplomas: the Master in Laparoscopic Pelvic Surgery and the Master in Hysteroscopy. The complexity of modern surgery has increased the demands and challenges to surgical education and the quality control. This programme is based on the best available scientific evidence, and it counteracts the problem of the traditional surgical apprentice-tutor model. It is seen as a major step toward standardisation of endoscopic surgical training in general.

The Effect on Performance Time and Quality of the Knots after Mono or Bimanual Training of Laparoscopic Intracorporeal Knot Tying according to the Gladiator Rule Technique

“…3 It seems appropriate that, in addition to the skills required for open surgery (manual dexterity, knowledge of anatomy and surgical techniques), the laparoscopic surgeon develops other laparoscopy-specific skills, such as depth perception in a two-dimensional screen, hand-eye coordination, bimanual coordination, the handling of long instruments that provide less tactile feedback, and, finally, the knowledge of the laparoscopic operating room. 4,5 Although training in surgery is challenging, it seems obvious that a surgeon needs to have theoretical and practical knowledge and skills prior to performing a laparoscopic surgical intervention. 4,[6][7][8][9] Training with synthetic rubber models that mimic human tissues offers an opportunity for beginners to practice unfamiliar techniques in an artificial environment, thereby maximizing the acquisition and retention of knowledge in laparoscopy, 10 and potentially leading to a decrease in errors in the operating room 11 and optimizing the surgical time.…”

Operative and diagnostic hysteroscopy: A novel learning model combining new animal models and virtual reality simulation

“…The causes for this progressive switch are multiple and diverse. Simulation, if not already a fundamental part of the training curriculum for surgical residents, is to become pivotal in training future surgeon, as demonstrated by such programs as the Gynaecological endoscopic surgical education and assessment [22] diploma and the French Guidelines for Simulation for health professionals [9]. From a purely economical perspective, training residents bears a significant cost on Operating Room (OR) costs as recent studies have shown [23,24], both financially and on allocated operative time.…”

The Career Self Evaluation in Improving the Quality of Higher Education

“…There are different ways of carrying out the self-assessment, and each institution adopts the methodology that best fits its organizational culture, so that several ways of carrying it out are designed by designing specific instruments, including from an inclusive perspective [8]. For what is stated, "The problem does not lie in the shortage of instruments, but in the lack of a clear scheme shared by the agents who must carry out the self-assessment processes" [9]. However, we agree that the self-evaluation pursues two fundamental purposes: a) Identify the problems, achievements, successes, and difficulties and b) Propose corrective and commit to the review and adjustment to ensure a permanent process of qualitative improvement [9].…”

“…For what is stated, "The problem does not lie in the shortage of instruments, but in the lack of a clear scheme shared by the agents who must carry out the self-assessment processes" [9]. However, we agree that the self-evaluation pursues two fundamental purposes: a) Identify the problems, achievements, successes, and difficulties and b) Propose corrective and commit to the review and adjustment to ensure a permanent process of qualitative improvement [9]. Therefore not all AI processes assume the same characteristics, those that depend on the model that is put into practice and the conditions of the educational system in which they take place [10].…”