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Surgical skills curricula in American College of Surgeons Accredited Education Institutes
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Scientific Poster Presentations: 2015 Clinical Congress
Successful integration of military tactical requirements into a civilian training paradigm: Advanced Trauma Life Support - Operational Emphasis (ATLS-OE) Travis M Polk, MD, FACS, Zsolt T Stockinger, MD, FACS, Matthew J Martin, MD, FACS, Kirby R Gross, MD, FACS, Jeffrey A Bailey, MD, FACS Naval Medical Center Portsmouth, Portsmouth, VA; Joint Trauma System, San Antonio, TX; Madigan Army Medical Center, Tacoma, WA INTRODUCTION: Advanced Trauma Life Support (ATLS) has been the cornerstone of military and civilian trauma training in the United States for many years, yet its utility remains questionable for the military physician constrained by tactical limitations. METHODS: In collaboration with the American College of Surgeons Committee on Trauma (ACS-COT), tri-service surgeons developed the ATLS-Operational Emphasis (ATLS-OE) curriculum which includes 4 novel lectures, supplemental slides for the current ATLS lectures, and a tourniquet skills session. A pilot program was executed at the Defense Medical Readiness Training Institute (DMRTI), the nation’s highest volume ATLS site. Military course directors with previous wartime deployment experience concurrently administered demonstration ATLS-OE and standard ATLS courses from November 2013 to December 2014. Upon successful course completion, all students received standard ATLS cards. RESULTS: 444 ATLS and 207 ATLS-OE students were enrolled over 13 months. ATLS and ATLS-OE post-test scores (82.23 vs 82.19, p¼0.523) and course pass rates (96.6 vs 94.7, p¼0.28) were similar. Additionally, the DMRTI mean score for either course and the ATLS 9th edition historical averages for all North American courses and all military courses did not differ. Nonphysician students scored significantly lower (74.66 vs 82.57, p <0.001) and were less likely to pass (72.4 vs 97.1%, p<0.001) in all courses. ATLS-OE required minimal additional time and equipment during a 2.5 day course. CONCLUSIONS: Civilian life support courses can be successfully adapted to meet military training needs. The US military will transition exclusively to ATLS-OE courses within the next year and further curriculum refinement is in progress.
Surgical skills curricula in American College of Surgeons Accredited Education Institutes Iman Ghaderi, MD, Shimae Fitzgibbons, Yusuke Watanabe, MD, Alexander S Lachapelle, John T Paige, MD, FACS University of Arizona, Tucson, AZ; Georgetown University Hospital, Washington, DC; McGill University, Montreal, QC INTRODUCTION: With the increasing adoption of simulationbased surgical training, a wide range of curricula and assessment tools have been introduced. We sought to better define the heterogeneous nature of currently implemented simulation-based
J Am Coll Surg
curricula in American College of Surgeons Accredited Education Institutes (ACS-AEIs). METHODS: A 25-question online survey was sent to all ACS-AEI programs. RESULTS: The response rate was 53% (42 out of 79 programs). ACS-AEI sites were primarily used by general surgery (92%) and obstetrics and gynecology(90%) programs. While 75% of responding programs teach some elements of the ACS/APDS Surgical Skills curriculum, only 42.5% implement the entire curriculum. Almost all responding programs (98%) have independently developed their own curricula to teach surgical skills. Feasibility (81%), cost (67%) and evidence for effectiveness (60%) were reasons for adoption of their existing curricula. Nearly all programs (98%) use operative assessment tools for assessing resident performance and more than half of the programs reported use of Messick’s unitary framework of validity. The majority of responding programs (74%) use “home grown” simulators designed in their institution. Most programs have faculty development programs (86%) and financial support from their academic institutions (88.5%). Other stated sources of funding were industry (25%), revenue from course fees (25%), the private sector (17%), and endowment (14%). CONCLUSIONS: This study provides specific information regarding simulation-based curricula at ACS-AEI skills labs, demonstrating several broad trends in curriculum implementation. Future efforts will focus on creating a current and accessible interface for this type of data, to promote information sharing related to the ACS/APDS Skills curriculum implementation.
What are the barriers to hiring and promoting women in surgery? Alison M Fecher, MD, FACS, Nakul Valsangkar, MD, Grace S Rozycki, MD, FACS, Casi Blanton, Julie A Freischlag, MD, FACS, Teresa M Bell, PhD, Teresa Zimmers, PhD, Leonidas G Koniaris, MD, MBA, FACS Indiana University Purdue University Indianapolis, Indianapolis, IN INTRODUCTION: The objectives of this study are to define potential disparities in academic output, NIH funding, and academic rank for faculty women in surgery. METHODS: Eighty individual academic metrics for 4,107 faculty at the top-50 university-based and 5 hospital-based NIH funded departments of surgery were collected and analyzed. RESULTS: Overall, 21.5% of surgical faculty are women. The percentage of female faculty is highest in science/research (41%), surgical oncology (34%), and general surgery (24%), and lowest in cardiothoracic surgery (9%). Female faculty are less likely to be full professors (22.7% vs 41.2%) or division chiefs (6.2% vs 13.6%) than the male faculty. The fraction of women full professors varies
Scientific Poster Presentations: 2015 Clinical Congress
Successful integration of military tactical requirements into a civilian training paradigm: Advanced Trauma Life Support - Operational Emphasis (ATLS-OE) Travis M Polk, MD, FACS, Zsolt T Stockinger, MD, FACS, Matthew J Martin, MD, FACS, Kirby R Gross, MD, FACS, Jeffrey A Bailey, MD, FACS Naval Medical Center Portsmouth, Portsmouth, VA; Joint Trauma System, San Antonio, TX; Madigan Army Medical Center, Tacoma, WA INTRODUCTION: Advanced Trauma Life Support (ATLS) has been the cornerstone of military and civilian trauma training in the United States for many years, yet its utility remains questionable for the military physician constrained by tactical limitations. METHODS: In collaboration with the American College of Surgeons Committee on Trauma (ACS-COT), tri-service surgeons developed the ATLS-Operational Emphasis (ATLS-OE) curriculum which includes 4 novel lectures, supplemental slides for the current ATLS lectures, and a tourniquet skills session. A pilot program was executed at the Defense Medical Readiness Training Institute (DMRTI), the nation’s highest volume ATLS site. Military course directors with previous wartime deployment experience concurrently administered demonstration ATLS-OE and standard ATLS courses from November 2013 to December 2014. Upon successful course completion, all students received standard ATLS cards. RESULTS: 444 ATLS and 207 ATLS-OE students were enrolled over 13 months. ATLS and ATLS-OE post-test scores (82.23 vs 82.19, p¼0.523) and course pass rates (96.6 vs 94.7, p¼0.28) were similar. Additionally, the DMRTI mean score for either course and the ATLS 9th edition historical averages for all North American courses and all military courses did not differ. Nonphysician students scored significantly lower (74.66 vs 82.57, p <0.001) and were less likely to pass (72.4 vs 97.1%, p<0.001) in all courses. ATLS-OE required minimal additional time and equipment during a 2.5 day course. CONCLUSIONS: Civilian life support courses can be successfully adapted to meet military training needs. The US military will transition exclusively to ATLS-OE courses within the next year and further curriculum refinement is in progress.
Surgical skills curricula in American College of Surgeons Accredited Education Institutes Iman Ghaderi, MD, Shimae Fitzgibbons, Yusuke Watanabe, MD, Alexander S Lachapelle, John T Paige, MD, FACS University of Arizona, Tucson, AZ; Georgetown University Hospital, Washington, DC; McGill University, Montreal, QC INTRODUCTION: With the increasing adoption of simulationbased surgical training, a wide range of curricula and assessment tools have been introduced. We sought to better define the heterogeneous nature of currently implemented simulation-based
J Am Coll Surg
curricula in American College of Surgeons Accredited Education Institutes (ACS-AEIs). METHODS: A 25-question online survey was sent to all ACS-AEI programs. RESULTS: The response rate was 53% (42 out of 79 programs). ACS-AEI sites were primarily used by general surgery (92%) and obstetrics and gynecology(90%) programs. While 75% of responding programs teach some elements of the ACS/APDS Surgical Skills curriculum, only 42.5% implement the entire curriculum. Almost all responding programs (98%) have independently developed their own curricula to teach surgical skills. Feasibility (81%), cost (67%) and evidence for effectiveness (60%) were reasons for adoption of their existing curricula. Nearly all programs (98%) use operative assessment tools for assessing resident performance and more than half of the programs reported use of Messick’s unitary framework of validity. The majority of responding programs (74%) use “home grown” simulators designed in their institution. Most programs have faculty development programs (86%) and financial support from their academic institutions (88.5%). Other stated sources of funding were industry (25%), revenue from course fees (25%), the private sector (17%), and endowment (14%). CONCLUSIONS: This study provides specific information regarding simulation-based curricula at ACS-AEI skills labs, demonstrating several broad trends in curriculum implementation. Future efforts will focus on creating a current and accessible interface for this type of data, to promote information sharing related to the ACS/APDS Skills curriculum implementation.
What are the barriers to hiring and promoting women in surgery? Alison M Fecher, MD, FACS, Nakul Valsangkar, MD, Grace S Rozycki, MD, FACS, Casi Blanton, Julie A Freischlag, MD, FACS, Teresa M Bell, PhD, Teresa Zimmers, PhD, Leonidas G Koniaris, MD, MBA, FACS Indiana University Purdue University Indianapolis, Indianapolis, IN INTRODUCTION: The objectives of this study are to define potential disparities in academic output, NIH funding, and academic rank for faculty women in surgery. METHODS: Eighty individual academic metrics for 4,107 faculty at the top-50 university-based and 5 hospital-based NIH funded departments of surgery were collected and analyzed. RESULTS: Overall, 21.5% of surgical faculty are women. The percentage of female faculty is highest in science/research (41%), surgical oncology (34%), and general surgery (24%), and lowest in cardiothoracic surgery (9%). Female faculty are less likely to be full professors (22.7% vs 41.2%) or division chiefs (6.2% vs 13.6%) than the male faculty. The fraction of women full professors varies