Utilising the Delphi Process to Develop a Proficiency-based Progression Train-the-trainer Course for Robotic Surgery Training

Collins, Justin; Levy, Jeffrey S.; Stefanidis, Dimitrios; Gallagher, Anthony G.; Coleman, Mark; Cecil, Tom; Ericsson, Anders K.; Mottrie, Alexandre; Wiklund, Peter; Ahmed, Kamran; Pratschke, Johann; Casali, Gianluca; Ghazi, Ahmed; Gómez, Marcos; Hung, Andrew J.; Arnold, Anne Jurmu; Dunning, Joel; Martino, Martin A; Vaz, Carlos; Friedman, Eric; Baste, Jean-Marc; Bergamaschi, Roberto; Feins, Richard H.; Earle, David; Pusic, Martin; Montgomery, Owen; Pugh, Carla M.; Satava, Richard M.

doi:10.1016/j.eururo.2018.12.044

Cited by 75 publications

(45 citation statements)

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“…The agreed “core” steps can be used for education (e.g. operative video annotation), surgical skills assessment, and the development of models and simulators [ 13 , 19 , 22 , 38 ]. Similarly, the agreed “optional” steps highlight areas of heterogeneity of practice that will benefit from further research—most notably in skull base reconstruction (closure phase) and surgical exposure (nasal, sphenoid, sellar phases) [ 2 , 3 , 5 , 7 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are many applications of surgical workflows—including education and training; surgical assessment; research; and technology development. In relation to education, highlighting the core components of operations is a useful learning resource for training surgeons and has been used to develop educational curricula, courses and simulators [ 13 , 38 ]. Similarly, these workflows can be used to inform objective assessment instruments specific to particular operations, for example, Knight et al combined a consensus-driven surgical steps workflow for laparoscopic hysterectomy with an established skills assessment form (Objective structured assessment of technical skill or OSATS) to generate a reliable and specific measure of procedural proficiency [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

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Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection

et al. 2021

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Purpose Surgical workflow analysis seeks to systematically break down operations into hierarchal components. It facilitates education, training, and understanding of surgical variations. There are known educational demands and variations in surgical practice in endoscopic transsphenoidal approaches to pituitary adenomas. Through an iterative consensus process, we generated a surgical workflow reflective of contemporary surgical practice. Methods A mixed-methods consensus process composed of a literature review and iterative Delphi surveys was carried out within the Pituitary Society. Each round of the survey was repeated until data saturation and > 90% consensus was reached. Results There was a 100% response rate and no attrition across both Delphi rounds. Eighteen international expert panel members participated. An extensive workflow of 4 phases (nasal, sphenoid, sellar and closure) and 40 steps, with associated technical errors and adverse events, were agreed upon by 100% of panel members across rounds. Both core and case-specific or surgeon-specific variations in operative steps were captured. Conclusions Through an international expert panel consensus, a workflow for the performance of endoscopic transsphenoidal pituitary adenoma resection has been generated. This workflow captures a wide range of contemporary operative practice. The agreed “core” steps will serve as a foundation for education, training, assessment and technological development (e.g. models and simulators). The “optional” steps highlight areas of heterogeneity of practice that will benefit from further research (e.g. methods of skull base repair). Further adjustments could be made to increase applicability around the world.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection

et al. 2021

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“…This model was felt appropriate as it has been widely used for a number of years and has been shown to be adaptable to different technical areas, including laparoscopic surgery [19]. The course was developed using results from a previous international Delphi process to develop and reach content validation for a curriculum for robotic surgery training [21]. During the first day of the course, the practical components were taught using a dry laboratory model to train setting up of the ports and camera positioning.…”

Section: Methodsmentioning

confidence: 99%

European Society of Coloproctology Colorectal Robotic Surgery Training for the Trainers Course – the first pilot experience

et al. 2020

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Aim Currently, there is no established colorectal specific robotic surgery Train the Trainer (TTT) course. The aim was to develop and evaluate such a course which can then be further developed to be incorporated within the planned European Society of Coloproctology (ESCP)/European School of Coloproctology (ESC) robotic colorectal surgery training curriculum. Method After identifying the need for such a course within a training programme, the course was developed by a subgroup of the ESCP/ESC. A scoping literature review was performed and the content and materials for the course were developed by a team consisting of two gastroenterologists with a combined experience of 30 years of facilitating TTT courses, a robotic surgeon and proctor with laparoscopic TTT faculty experience and experienced robotic and laparoscopic colorectal trainers. The course was evaluated by asking delegates to complete pre-and post-course questionnaires. Results There were eight delegates on the course from across Europe. Delegates increased their knowledge of each of the course learning objectives and identified learning points in order to change practice. The feedback from the delegates of the course was positive across several areas and all felt that they had achieved their own personal objectives in attending the course. Conclusion This pilot robotic colorectal TTT course has achieved its aim and demonstrated many positives. There is a need for such a course and the evaluation processes have provided opportunities for reflection, which will allow the development/tailoring of future robotic colorectal TTT courses to help develop robotic training further.

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“…These methodologies include problem-based learning, evidence-based medicine, and, more recently, entrustable professional activities [5]. All of these methods consider the learning of theoretical knowledge through pedagogical methods and the acquisition of technical and nontechnical skills, both motor and cognitive, to be the main objectives of the surgeon's curriculum [6]. From this point of view, the teaching of surgery is a multidimensional process that includes a wide variety of activities with the aim of obtaining autonomy when performing specific surgical procedures.…”

Section: Santiago Camachomentioning

confidence: 99%

The Incorporating of 3-Dimensional Skills on Surgery Education Would Improve Curricula

Camacho

2019

Journal of Investigative Surgery

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Utilising the Delphi Process to Develop a Proficiency-based Progression Train-the-trainer Course for Robotic Surgery Training

Cited by 75 publications

References 44 publications

Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection

Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection

European Society of Coloproctology Colorectal Robotic Surgery Training for the Trainers Course – the first pilot experience

The Incorporating of 3-Dimensional Skills on Surgery Education Would Improve Curricula

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