How many cases do instructor class pediatric surgeons need to experience to be an independent operator in performing advanced endoscopic surgery? A nationwide survey to establish an ideal curriculum for pediatric endoscopic surgery in Japan

Abstract

Purpose: To ensure the safe spread of pediatric endoscopic surgery, it is essential to build a training curriculum, and a survey of the current situation in Japan is necessary. The present study assessed an e cient training curriculum by clarifying instructor class pediatric surgeons' experiences, including autonomy when performing advanced endoscopic surgeries.Methods: An online nationwide questionnaire survey was conducted among pediatric surgeons who had Endoscopic Surgical Skill Quali cation (ESSQ) and board-certi ed instructors who had skills comparable to ESSQ. We assessed participants' training experience, opinions concerning the ideal training curriculum and the correlation between surgical experience and the level of autonomy. The Zwisch scale was used to assess autonomy.Results: Fifty-two participants responded to the survey (response rate: 86.7%). Only 57.7% of the respondents felt that they had received su cient endoscopic surgery training. Most respondents considered an educational curriculum for endoscopic surgery including off-the-job training essential during the training period. Autonomy had been acquired after experiencing two to three cases for most advanced endoscopic surgeries.Conclusion: This rst nationwide survey in Japan showed that instructor class pediatric surgeons acquired autonomy after experiencing two to three for most advanced endoscopic surgeries. Our ndings suggest that training, especially off-the-job training, has been insu cient.