- Email: [email protected]
Efforts to advance simulation-based surgical education through the American College of Surgeons-accredited Education Institutes
Simulation-Based Surgical Education Efforts to advance simulation-based surgical education through the American College of Surgeons-accredited Education Institutes Ajit K. Sachdeva, MD, FRCSC, FACS, Chicago, IL
From the Division of Education, American College of Surgeons, Chicago, IL
THE
USE OF SIMULATION IN INNOVATIVE SURGICAL EDUCA-
continues to receive significant attention. Simulation-based surgical education is key in efforts to improve the quality of surgical care, enhance patient safety, and decrease the risk of liability. Individuals and teams can achieve proficiency in safe and controlled environments prior to working with patients, which remains an ethical imperative for all health-care professionals. The core competencies defined by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties and the requirements for Maintenance of Certification also may be addressed through simulation-based surgical education. The rapid advances in science and technology and the development of new procedures require surgeons and members of surgical teams to be trained in safe performance of new procedures and use of emerging technologies, and their knowledge and skills need to be verified using valid and reliable evaluation tools.1 Simulation plays a central role in such efforts. The achievement of expertise requires deliberate practice, specific and timely feedback, and the establishment of progressively higher performance goals.2 Educational interventions designed to achieve expertise are facilitated greatly by the use of simulation. Maintenance of knowledge and skills, especially in
TION
Accepted for publication March 5, 2010. Reprint requests: Ajit K. Sachdeva, MD, FRCSC, FACS, Division of Education, American College of Surgeons, 633 N. Saint Clair Street, Chicago, IL 60611. E-mail: [email protected]. Surgery 2010;147:612-3. 0039-6060/$ - see front matter Ó 2010 Mosby, Inc. All rights reserved. doi:10.1016/j.surg.2010.03.004
612 SURGERY
infrequently performed procedures, and reentry into surgical practice after a period of absence also may be addressed through simulation. In addition, efficiencies in the operating room environment and other surgical settings may be improved through such educational interventions. The need for a system to offer innovative simulation-based surgical education to address the aforementioned needs and imperatives was recognized by the American College of Surgeons (ACS) Division of Education, and a decision was made to achieve the desired outcomes through the establishment of a national program to accredit simulation centers. Because of the broad focus on the spectrum of surgical knowledge and skills that needed to be addressed, the ACS Division of Education decided to call these accredited facilities education institutes instead of simulation centers. A model for the accreditation of education institutes was designed, validated, and launched in 2005 after approval by the ACS Board of Regents. This program aims to promote excellence in surgical care and enhance patient safety through the use of simulation.3,4 The goals of the program are to provide regional support for cutting-edge simulationbased surgical education, to increase access to innovative educational programs, to offer pre- and postcourse interventions, and to furnish requisite documentation after participation in educational programs. The accreditation model includes the following 3 principal standards: the learner groups served; the curricula offered; and the facilities, resources, and personnel available. A total of 21 criteria within these 3 standards are used to evaluate each facility that applies for accreditation. As of December 2009, the ACS, through its Division of Education, has accredited 50 education
Sachdeva 613
Surgery Volume 147, Number 5
institutes at Level I (comprehensive institutes) and 1 at Level II (basic institute). Of these accredited institutes, 42 are in the United States, 4 are in Canada, 1 is in the United Kingdom, 2 are in Sweden, 1 is in Greece, and 1 is in Israel. Additional applications for accreditation will continue to be reviewed, and institutes will continue to be accredited if they meet the standards and criteria for accreditation. All accredited institutes are required to go through a reaccreditation process every 3 years. The evolving trends in health care and education, increasing the focus on competencybased education, and the national efforts to implement strategies to promote surgery residents from one level to the next based on achievement of predefined milestones confirmed through demonstration of specific levels of knowledge and skills will continue to fuel the innovative activities of the of ACS-accredited Education Institutes. The Consortium of ACS-accredited Education Institutes has been created to explore the full potential of the ACS-accredited Education Institutes and to pursue new directions that previously were not possible. Opportunities for collaboration in continuing surgical education, residency education in surgery, interdisciplinary education, technology advancement, management and administration, and research and development are being pursued. An annual meeting of the Consortium of ACS-accredited Education Institutes is convened in the spring and includes a robust scientific program with oral and poster presentations based on the scholarly work of the ACS-accredited Education Institutes. The Second Annual Meeting of the Consortium of ACS-accredited Education Institutes was held on March 20--21, 2009. The program included 43 scientific presentations, of which 13 were oral paper presentations and 30 were posters. A relationship
was established with Surgery through which manuscripts based on the scientific presentations at the annual meetings of the Consortium of ACSaccredited Education Institutes would be peer reviewed and submitted to Surgery to be considered for publication. A total of 16 full-length manuscripts were received from the 2009 meeting. After rigorous peer review and revisions, 5 were accepted for publication, and the articles appear in this issue of Surgery. All 5 articles address key topics in the burgeoning field of simulation-based surgical education. As collaborative research and development endeavors of the Consortium of ACS-accredited Education Institutes continue to advance, large-scale multiinstitutional studies will be designed and conducted to answer a host of important questions. The new relationship between the Consortium of ACSaccredited Education Institutes and Surgery provides a unique opportunity to bring cutting-edge scholarly work from the field of simulation-based surgical education to the attention of the readers and to disseminate useful information that undoubtedly will raise new questions for future study.
REFERENCES 1. Sachdeva AK, Russell TR. Safe introduction of new procedures and emerging technologies in surgery: education, credentialing, and privileging. Surg Oncol Clin N Am 2007;16:101-14. 2. Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 2004;79:S70-81. 3. Sachdeva AK, Pellegrini CA, Johnson KA. Support for simulation-based surgical education through American College of Surgeons-Accredited Education Institutes. World J Surg 2008;32:196-207. 4. Pellegrini CA, Sachdeva AK, Johnson KA. Accreditation of education institutes by the American College of Surgeons: a new program following an old tradition. Bull Am Coll Surg 2006;91(3):8-12.
From the Division of Education, American College of Surgeons, Chicago, IL
THE
USE OF SIMULATION IN INNOVATIVE SURGICAL EDUCA-
continues to receive significant attention. Simulation-based surgical education is key in efforts to improve the quality of surgical care, enhance patient safety, and decrease the risk of liability. Individuals and teams can achieve proficiency in safe and controlled environments prior to working with patients, which remains an ethical imperative for all health-care professionals. The core competencies defined by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties and the requirements for Maintenance of Certification also may be addressed through simulation-based surgical education. The rapid advances in science and technology and the development of new procedures require surgeons and members of surgical teams to be trained in safe performance of new procedures and use of emerging technologies, and their knowledge and skills need to be verified using valid and reliable evaluation tools.1 Simulation plays a central role in such efforts. The achievement of expertise requires deliberate practice, specific and timely feedback, and the establishment of progressively higher performance goals.2 Educational interventions designed to achieve expertise are facilitated greatly by the use of simulation. Maintenance of knowledge and skills, especially in
TION
Accepted for publication March 5, 2010. Reprint requests: Ajit K. Sachdeva, MD, FRCSC, FACS, Division of Education, American College of Surgeons, 633 N. Saint Clair Street, Chicago, IL 60611. E-mail: [email protected]. Surgery 2010;147:612-3. 0039-6060/$ - see front matter Ó 2010 Mosby, Inc. All rights reserved. doi:10.1016/j.surg.2010.03.004
612 SURGERY
infrequently performed procedures, and reentry into surgical practice after a period of absence also may be addressed through simulation. In addition, efficiencies in the operating room environment and other surgical settings may be improved through such educational interventions. The need for a system to offer innovative simulation-based surgical education to address the aforementioned needs and imperatives was recognized by the American College of Surgeons (ACS) Division of Education, and a decision was made to achieve the desired outcomes through the establishment of a national program to accredit simulation centers. Because of the broad focus on the spectrum of surgical knowledge and skills that needed to be addressed, the ACS Division of Education decided to call these accredited facilities education institutes instead of simulation centers. A model for the accreditation of education institutes was designed, validated, and launched in 2005 after approval by the ACS Board of Regents. This program aims to promote excellence in surgical care and enhance patient safety through the use of simulation.3,4 The goals of the program are to provide regional support for cutting-edge simulationbased surgical education, to increase access to innovative educational programs, to offer pre- and postcourse interventions, and to furnish requisite documentation after participation in educational programs. The accreditation model includes the following 3 principal standards: the learner groups served; the curricula offered; and the facilities, resources, and personnel available. A total of 21 criteria within these 3 standards are used to evaluate each facility that applies for accreditation. As of December 2009, the ACS, through its Division of Education, has accredited 50 education
Sachdeva 613
Surgery Volume 147, Number 5
institutes at Level I (comprehensive institutes) and 1 at Level II (basic institute). Of these accredited institutes, 42 are in the United States, 4 are in Canada, 1 is in the United Kingdom, 2 are in Sweden, 1 is in Greece, and 1 is in Israel. Additional applications for accreditation will continue to be reviewed, and institutes will continue to be accredited if they meet the standards and criteria for accreditation. All accredited institutes are required to go through a reaccreditation process every 3 years. The evolving trends in health care and education, increasing the focus on competencybased education, and the national efforts to implement strategies to promote surgery residents from one level to the next based on achievement of predefined milestones confirmed through demonstration of specific levels of knowledge and skills will continue to fuel the innovative activities of the of ACS-accredited Education Institutes. The Consortium of ACS-accredited Education Institutes has been created to explore the full potential of the ACS-accredited Education Institutes and to pursue new directions that previously were not possible. Opportunities for collaboration in continuing surgical education, residency education in surgery, interdisciplinary education, technology advancement, management and administration, and research and development are being pursued. An annual meeting of the Consortium of ACS-accredited Education Institutes is convened in the spring and includes a robust scientific program with oral and poster presentations based on the scholarly work of the ACS-accredited Education Institutes. The Second Annual Meeting of the Consortium of ACS-accredited Education Institutes was held on March 20--21, 2009. The program included 43 scientific presentations, of which 13 were oral paper presentations and 30 were posters. A relationship
was established with Surgery through which manuscripts based on the scientific presentations at the annual meetings of the Consortium of ACSaccredited Education Institutes would be peer reviewed and submitted to Surgery to be considered for publication. A total of 16 full-length manuscripts were received from the 2009 meeting. After rigorous peer review and revisions, 5 were accepted for publication, and the articles appear in this issue of Surgery. All 5 articles address key topics in the burgeoning field of simulation-based surgical education. As collaborative research and development endeavors of the Consortium of ACS-accredited Education Institutes continue to advance, large-scale multiinstitutional studies will be designed and conducted to answer a host of important questions. The new relationship between the Consortium of ACSaccredited Education Institutes and Surgery provides a unique opportunity to bring cutting-edge scholarly work from the field of simulation-based surgical education to the attention of the readers and to disseminate useful information that undoubtedly will raise new questions for future study.
REFERENCES 1. Sachdeva AK, Russell TR. Safe introduction of new procedures and emerging technologies in surgery: education, credentialing, and privileging. Surg Oncol Clin N Am 2007;16:101-14. 2. Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 2004;79:S70-81. 3. Sachdeva AK, Pellegrini CA, Johnson KA. Support for simulation-based surgical education through American College of Surgeons-Accredited Education Institutes. World J Surg 2008;32:196-207. 4. Pellegrini CA, Sachdeva AK, Johnson KA. Accreditation of education institutes by the American College of Surgeons: a new program following an old tradition. Bull Am Coll Surg 2006;91(3):8-12.