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Do increased training requirements in gastrointestinal endoscopy and advanced laparoscopy necessitate a paradigm shift? A survey of program directors in surgery.
J Surg Educ. 2008 Nov-Dec; 65(6):418-30.JS

Abstract

BACKGROUND

Many modifications to the traditional residency model contribute to the ongoing paradigm shift in surgical education; yet, the frequency and manner by which such changes occur at various institutions is less clear. To address this issue, our study examined the variability in endoscopy and laparoscopy training, the potential impact of new requirements, and opinions of Program Directors in Surgery (PDs).

METHODS

A 22-item online survey was sent to 251 PDs in the United States. Appropriate parametric tests determined significance.

RESULTS

In all, 105 (42%) PDs responded. No difference existed in response rates among university (56.2%), university-affiliated/community (30.5%), or community (13.3%) program types (p = 0.970). Surgeons alone (46.7%) conducted most endoscopy training with a trend toward multidisciplinary teams (43.8%). A combination of fellowship-trained minimally invasive surgeons and other surgeon types (66.7%) commonly provided laparoscopy training. For adequate endoscopy experience in the future, most PDs (74.3%) plan to require a formal flexible endoscopy rotation (p < 0.001). For laparoscopy, PDs intend for more minimally invasive surgery (59%) as well as colon and rectal surgery (53.4%) rotations (both p < 0.001). Respondents feel residents will perform diagnostic endoscopy (86.7%) and basic laparoscopy (100%) safely on graduation. Fewer PDs confirm graduates will safely practice therapeutic endoscopy (12.4%) and advanced laparoscopy (52.4%). PDs believe increased requirements for endoscopy and laparoscopy will improve procedural competency (79% and 92.4%, respectively) and strengthen the fields of surgical endoscopy and minimally invasive surgery (55.2% and 68.6%, respectively). Less believe new requirements necessitate redesign of cognitive and technical skills curricula (33.3% endoscopy, 28.6% laparoscopy; p = 0.018). A national surgical education curriculum should be a required component of resident training, according to 79% of PDs.

CONCLUSIONS

PDs employ and may implement varied tools to meet the increased requirements in endoscopy and laparoscopy. With such variability in educational methodology, establishment of a national surgical education curriculum is very important to most PDs.

Authors+Show Affiliations

Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia 30912, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19059172

Citation

Bittner, James G., et al. "Do Increased Training Requirements in Gastrointestinal Endoscopy and Advanced Laparoscopy Necessitate a Paradigm Shift? a Survey of Program Directors in Surgery." Journal of Surgical Education, vol. 65, no. 6, 2008, pp. 418-30.
Bittner JG, Coverdill JE, Imam T, et al. Do increased training requirements in gastrointestinal endoscopy and advanced laparoscopy necessitate a paradigm shift? A survey of program directors in surgery. J Surg Educ. 2008;65(6):418-30.
Bittner, J. G., Coverdill, J. E., Imam, T., Deladisma, A. M., Edwards, M. A., & Mellinger, J. D. (2008). Do increased training requirements in gastrointestinal endoscopy and advanced laparoscopy necessitate a paradigm shift? A survey of program directors in surgery. Journal of Surgical Education, 65(6), 418-30. https://doi.org/10.1016/j.jsurg.2008.05.001
Bittner JG, et al. Do Increased Training Requirements in Gastrointestinal Endoscopy and Advanced Laparoscopy Necessitate a Paradigm Shift? a Survey of Program Directors in Surgery. J Surg Educ. 2008 Nov-Dec;65(6):418-30. PubMed PMID: 19059172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do increased training requirements in gastrointestinal endoscopy and advanced laparoscopy necessitate a paradigm shift? A survey of program directors in surgery. AU - Bittner,James G,4th AU - Coverdill,James E, AU - Imam,Toufic, AU - Deladisma,Adeline M, AU - Edwards,Michael A, AU - Mellinger,John D, PY - 2008/03/21/received PY - 2008/04/29/revised PY - 2008/05/01/accepted PY - 2008/12/9/pubmed PY - 2009/3/6/medline PY - 2008/12/9/entrez SP - 418 EP - 30 JF - Journal of surgical education JO - J Surg Educ VL - 65 IS - 6 N2 - BACKGROUND: Many modifications to the traditional residency model contribute to the ongoing paradigm shift in surgical education; yet, the frequency and manner by which such changes occur at various institutions is less clear. To address this issue, our study examined the variability in endoscopy and laparoscopy training, the potential impact of new requirements, and opinions of Program Directors in Surgery (PDs). METHODS: A 22-item online survey was sent to 251 PDs in the United States. Appropriate parametric tests determined significance. RESULTS: In all, 105 (42%) PDs responded. No difference existed in response rates among university (56.2%), university-affiliated/community (30.5%), or community (13.3%) program types (p = 0.970). Surgeons alone (46.7%) conducted most endoscopy training with a trend toward multidisciplinary teams (43.8%). A combination of fellowship-trained minimally invasive surgeons and other surgeon types (66.7%) commonly provided laparoscopy training. For adequate endoscopy experience in the future, most PDs (74.3%) plan to require a formal flexible endoscopy rotation (p < 0.001). For laparoscopy, PDs intend for more minimally invasive surgery (59%) as well as colon and rectal surgery (53.4%) rotations (both p < 0.001). Respondents feel residents will perform diagnostic endoscopy (86.7%) and basic laparoscopy (100%) safely on graduation. Fewer PDs confirm graduates will safely practice therapeutic endoscopy (12.4%) and advanced laparoscopy (52.4%). PDs believe increased requirements for endoscopy and laparoscopy will improve procedural competency (79% and 92.4%, respectively) and strengthen the fields of surgical endoscopy and minimally invasive surgery (55.2% and 68.6%, respectively). Less believe new requirements necessitate redesign of cognitive and technical skills curricula (33.3% endoscopy, 28.6% laparoscopy; p = 0.018). A national surgical education curriculum should be a required component of resident training, according to 79% of PDs. CONCLUSIONS: PDs employ and may implement varied tools to meet the increased requirements in endoscopy and laparoscopy. With such variability in educational methodology, establishment of a national surgical education curriculum is very important to most PDs. SN - 1931-7204 UR - https://www.unboundmedicine.com/medline/citation/19059172/Do_increased_training_requirements_in_gastrointestinal_endoscopy_and_advanced_laparoscopy_necessitate_a_paradigm_shift_A_survey_of_program_directors_in_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1931-7204(08)00131-1 DB - PRIME DP - Unbound Medicine ER -