Section of Thoracic Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada.
Division of Thoracic Surgery, University of Toronto, Toronto, Ontario, Canada.
J Surg Educ. 2018 Jul-Aug;75(4):1106-1112. doi: 10.1016/j.jsurg.2017.11.008. Epub 2017 Dec 13.
The use surgical simulation across all subspecialties has gained widespread adoption in the last decade. A number of factors, including the small number of trainees, identified gaps in surgical skill training from cross-sectional surveys, increased national collaboration, and support from the national specialty committee identified a need to construct a surgical skills "bootcamp" in thoracic surgery in Canada.
The goals of the surgical skills bootcamp, as identified by the residency training program directors and the national specialty committee were to create a national, centralized, simulation-based skills workshop that focused on key foundational procedures within thoracic surgery, particularly those identified as areas of weakness by former residents; to smooth the transition to intraoperative teaching; to provide exposure to important but not necessarily universally available procedures such as advanced endoscopy; to teach non-medical expert competencies, and lastly to provide a venue for networking for residents across the country.
The curriculum committee has constructed a 3.5 day curriculum, with a focus on hands-on skills simulation, as well as lectures, on a breadth of topics including benign esophageal disorders, lung cancer staging, minimally invasive lung surgery, crisis management and advanced bronchoscopy and endoscopy. All residents across the country attend as well as faculty from a variety of institutions.
The course is hosted centrally at the University of Toronto, Ontario over 3.5 days. A combination of auditorium and both animal and human operating room facilities are utilized.
A needs-assessment based on a formal meeting of the program directors, as well feedback from surveys identified the target areas for curriculum development. A committee of interested faculty developed the content as well as the local construct and logistics required. Iterative feedback has evolved the duration and content over the initial 3 years.
Through formal resident feedback, national subspecialty committee review, and program director meetings the support for the bootcamp has been overwhelmingly positive. Specific resident feedback for structure, content and specific simulations has been favorable, but has also been used to modify the program.
In response to identified weaknesses in training, with the support of the national specialty committee, the residency program directors, and the faculty at the University of Toronto, an intensive simulation based thoracic surgery bootcamp has successfully been created for Canadian thoracic surgery residents.
在过去十年中,所有亚专业都广泛采用了手术模拟。包括学员人数少、横断面调查发现手术技能培训存在差距、国家合作增加以及国家专业委员会的支持等在内的一些因素,都表明加拿大胸外科需要建立一个手术技能“训练营”。
正如住院医师培训计划主任和国家专业委员会所确定的,胸外科技能训练营的目标是创建一个全国性的、集中的、基于模拟的技能研讨会,重点关注胸外科的关键基础程序,特别是那些前住院医师认为薄弱的领域;顺利过渡到术中教学;提供接触重要但不一定普遍可用的程序的机会,如高级内镜检查;教授非医学专家的能力,最后为全国的住院医师提供一个交流的场所。
课程委员会构建了一个为期 3.5 天的课程,重点是手技能模拟,以及关于广泛主题的讲座,包括良性食管疾病、肺癌分期、微创肺手术、危机管理以及高级支气管镜和内镜。全国各地的住院医师以及来自各种机构的教师都参加了课程。
该课程在安大略省多伦多大学集中举办,为期 3.5 天。结合礼堂以及动物和人体手术室设施使用。
基于计划主任的正式会议以及调查反馈的需求评估确定了课程开发的目标领域。一个有兴趣的教师委员会开发了内容以及所需的本地构建和后勤。在最初的 3 年中,迭代反馈不断改进课程的持续时间和内容。
通过正式的住院医师反馈、全国亚专业委员会审查以及计划主任会议,训练营得到了压倒性的积极支持。具体的住院医师对结构、内容和特定模拟的反馈是有利的,但也被用来修改该计划。
为了应对培训中的弱点,在国家专业委员会、住院医师培训计划主任和多伦多大学教师的支持下,为加拿大胸外科住院医师成功创建了一个强化模拟胸外科训练营。