Is the current training pathway for oncoplastic breast surgeons fit for purpose?

Kim, Bonglee; Dave, Rajiv; Potter, Shelley; Langlands, Fiona; Weston-Petrides, Gina; Ashken, L.; Benson, John R.; Tansley, Anne; Doughty, Julie

doi:10.1308/rcsbull.2019.69

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…In the context of Ireland and the United Kingdom, breast surgery and, in particular, oncoplastic breast surgery is emerging as a distinct sub-specialty. 22 The above Needs Assessment Framework therefore provides a systematic method of generating content for simulation-based assessment, though it may need to be adapted to account for national or local educational contexts and resource considerations.…”

Section: Discussionmentioning

confidence: 99%

“…For example, while the management of appendicitis, gallbladder disease, abdominal wall, and inguinal hernias, the acute abdomen and benign anorectal disease feature in the list of 18 Entrustable Professional Activities generated by the American Board of Surgery, 21 further competencies are outlined, for example, in breast and thyroid surgery. In the context of Ireland and the United Kingdom, breast surgery and, in particular, oncoplastic breast surgery is emerging as a distinct sub-specialty 22 . The above Needs Assessment Framework therefore provides a systematic method of generating content for simulation-based assessment, though it may need to be adapted to account for national or local educational contexts and resource considerations.…”

Section: Discussionmentioning

confidence: 99%

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Generating a Prioritised List of Operative Procedures for Simulation-Based Assessment of General Surgery Trainees through Consensus

Toale,

Morris,

Konge

et al. 2023

Annals of Surgery

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Objective: to develop appropriate content for high-stakes simulation-based assessments of operative competence in general surgery training through consensus. Summary Background Data: Valid methods of summative operative competence assessment are required by competency-based training programmes in surgery. Method: An online Delphi consensus study was conducted. Procedures were derived from the competency expectations outlined by the Joint Commission on Surgical Training (JCST) curriculum 2021, and subsequent brainstorming. Procedures were rated according to their perceived importance, perceived procedural risk, how frequently they are performed, and feasibility, by a purposive sample of thirty surgical trainers and a five-person steering group. A modified Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES NAF) was applied to generated data in order to produce ranked procedural lists, which were returned to participants for re-prioritization. Results: Prioritised lists were generated for simulation-based operative competence assessments at two key stages of training; end of ‘phase 2’ prior to development of a sub-specialty interest, and end of ‘phase 3’ i.e. end-of-training certification. A total of 21 and 16 procedures were deemed suitable for assessments at each of these stages respectively. Conclusions: This study describes a national needs assessment approach to content generation for simulation-based assessments of operative competence in general surgery using Delphi consensus methodology. The prioritised procedural lists generated by this study can be used to further develop operative skill assessments for use in high-stakes scenarios such as trainee progression, entrustment and end-of-training certification prior to subsequent validity testing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Generating a Prioritised List of Operative Procedures for Simulation-Based Assessment of General Surgery Trainees through Consensus

Toale,

Morris,

Konge

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

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Trainees as primary operators do not significantly impact perioperative complication rates in breast surgery

Vu,

Jeganathan,

Ponniah

et al. 2024

The Surgeon

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Innovations for the future of breast surgery

Vidya

Leff

Green

et al. 2021

British Journal of Surgery

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Background Future innovations in science and technology with an impact on multimodal breast cancer management from a surgical perspective are discussed in this narrative review. The work was undertaken in response to the Commission on the Future of Surgery project initiated by the Royal College of Surgeons of England. Methods Expert opinion was sought around themes of surgical de-escalation, reduction in treatment morbidities, and improving the accuracy of breast-conserving surgery in terms of margin status. There was emphasis on how the primacy of surgical excision in an era of oncoplastic and reconstructive surgery is increasingly being challenged, with more effective systemic therapies that target residual disease burden, and permit response-adapted approaches to both breast and axillary surgery. Results Technologies for intraoperative margin assessment can potentially half re-excision rates after breast-conserving surgery, and sentinel lymph node biopsy will become a therapeutic procedure for many patients with node-positive disease treated either with surgery or chemotherapy as the primary modality. Genomic profiling of tumours can aid in the selection of patients for neoadjuvant and adjuvant therapies as well as prevention strategies. Molecular subtypes are predictive of response to induction therapies and reductive approaches to surgery in the breast or axilla. Conclusion Treatments are increasingly being tailored and based on improved understanding of tumour biology and relevant biomarkers to determine absolute benefit and permit delivery of cost-effective healthcare. Patient involvement is crucial for breast cancer studies to ensure relevance and outcome measures that are objective, meaningful, and patient-centred.

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Is the current training pathway for oncoplastic breast surgeons fit for purpose?

Abstract: We take a look at the results of a Mammary Fold members' survey to find out.

Cited by 6 publications

References 9 publications

Generating a Prioritised List of Operative Procedures for Simulation-Based Assessment of General Surgery Trainees through Consensus

Generating a Prioritised List of Operative Procedures for Simulation-Based Assessment of General Surgery Trainees through Consensus

Trainees as primary operators do not significantly impact perioperative complication rates in breast surgery

Innovations for the future of breast surgery

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