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07.12.2018 | Review Article

Introducing off-the-job training to cardiovascular surgical residency training: a new era of developing competent cardiovascular surgeons

verfasst von: Hitoshi Yokoyama

Erschienen in: Surgery Today | Ausgabe 4/2019

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Abstract

Purpose

This review summarizes the recent progress made in understanding the skill acquisition process of achieving expert status in various fields that require fine motor skills. We discuss the attempts to apply this progress to develop competent surgeons.

Methods

We reviewed the existing literature, using the keywords “surgical training”, “skill acquisition”, and “simulator-based training”, using Medline, as well as recent books and chapters related to these issues. We also summarized the role of simulator-based training in basic skill acquisition through deliberate practice. Other aspects of surgical skills, such as steps taken to improve motor skills, technical skill in the operating room, and competency level from novice to expert, were reviewed.

Results

The common element of practice to develop top-ranking experts in various fields is deliberate practice. Long-term repetitive practice is supported by the individual’s mental attitude: guts, resilience, initiative, tenancy (GRIT). GRIT can be imparted using a teaching method that supports a “growth mindset”.

Conclusions

Recent theoretical advances in skill acquisition can be applied to surgical residency training, while intense efforts are being made to improve the curriculum and training environment.
Literatur
1.
Zurück zum Zitat Carter BN. The fruition of Halsted’s concept of surgical training. Surgery. 1952;32:518–27.PubMed Carter BN. The fruition of Halsted’s concept of surgical training. Surgery. 1952;32:518–27.PubMed
2.
Zurück zum Zitat Reznick RK, Macrae H. Teaching surgical skills—changes in the Wind. N Engl J Med. 2006;355:2664–9.CrossRefPubMed Reznick RK, Macrae H. Teaching surgical skills—changes in the Wind. N Engl J Med. 2006;355:2664–9.CrossRefPubMed
3.
Zurück zum Zitat Fitts PM, Posner MI. Human performance. Belmont: Brooks/Cole Pub.; 1967. Fitts PM, Posner MI. Human performance. Belmont: Brooks/Cole Pub.; 1967.
5.
Zurück zum Zitat Ericsson KE. Peak: how to master almost anything. New York: Viking Press; 2016. Ericsson KE. Peak: how to master almost anything. New York: Viking Press; 2016.
6.
Zurück zum Zitat Ericsson KE, Charness N, Feltovich PJ, Hoffman RR. The Cambridge handbook of expertise and expert performance. New York: Cambridge university press; 2006.CrossRef Ericsson KE, Charness N, Feltovich PJ, Hoffman RR. The Cambridge handbook of expertise and expert performance. New York: Cambridge university press; 2006.CrossRef
7.
Zurück zum Zitat Duckworth A. Grit. The power of passion and perseverance. New York: Scribner; 2016. Duckworth A. Grit. The power of passion and perseverance. New York: Scribner; 2016.
8.
Zurück zum Zitat Dweck CS. Mindset: the new psychology of success. New York: Ballantine Books; 2007. Dweck CS. Mindset: the new psychology of success. New York: Ballantine Books; 2007.
9.
Zurück zum Zitat Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C,et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg. 1997;84:273–8.CrossRefPubMed Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C,et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg. 1997;84:273–8.CrossRefPubMed
10.
Zurück zum Zitat Birkmeyer JD, Finks JF, O`Reilly A, Oerline M, Carlin AM, Nunn AR, et al. Surgical skill and complication rates after bariatric surgery. N Engl J Med. 2013;369(15):1434–42.CrossRef Birkmeyer JD, Finks JF, O`Reilly A, Oerline M, Carlin AM, Nunn AR, et al. Surgical skill and complication rates after bariatric surgery. N Engl J Med. 2013;369(15):1434–42.CrossRef
11.
Zurück zum Zitat De Raet JM, Arroyo J, Büchner S, Siregard S, Andreas M, Halvorsen F, et al. How to build your own coronary anastomosis simulator from scratch. Interact Cardiovasc Thorac Surg. 2013;16(6):772–6.CrossRefPubMedPubMedCentral De Raet JM, Arroyo J, Büchner S, Siregard S, Andreas M, Halvorsen F, et al. How to build your own coronary anastomosis simulator from scratch. Interact Cardiovasc Thorac Surg. 2013;16(6):772–6.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Park Y, Yokoyama H. Simulator for surgical training. Kyobu-geka. 2018;71(10):779–87.PubMed Park Y, Yokoyama H. Simulator for surgical training. Kyobu-geka. 2018;71(10):779–87.PubMed
13.
Zurück zum Zitat Price J, Naik V, Boodhwani M, Brandys T, Hendry P, Lam BK. A randomized evaluation of simulation training on performance of vascular anastomosis on a high-fidelity in vivo model: the role of deliberate practice. J Thorac Cardiovasc Surg. 2011;142(3):496–501.CrossRefPubMed Price J, Naik V, Boodhwani M, Brandys T, Hendry P, Lam BK. A randomized evaluation of simulation training on performance of vascular anastomosis on a high-fidelity in vivo model: the role of deliberate practice. J Thorac Cardiovasc Surg. 2011;142(3):496–501.CrossRefPubMed
14.
Zurück zum Zitat Zilbert NR, St-Martin L, Regehr G, Gallinger S, Moulton CA. Planning to avoid trouble in the operating room: experts’ formulation of the preoperative plan. J Surg Educ. 2015;72(2):271–7.CrossRefPubMed Zilbert NR, St-Martin L, Regehr G, Gallinger S, Moulton CA. Planning to avoid trouble in the operating room: experts’ formulation of the preoperative plan. J Surg Educ. 2015;72(2):271–7.CrossRefPubMed
15.
Zurück zum Zitat Nesbitt JC, St Julien J, Absi TS, Ahmad RM, Grogan EL, Balaguer JM, et al. Tissue-based coronary surgery simulation: medical student deliberate practice can achieve equivalency to senior surgery residents. J Thorac Cardiovasc Surg. 2013;145(6):1453–9.CrossRefPubMed Nesbitt JC, St Julien J, Absi TS, Ahmad RM, Grogan EL, Balaguer JM, et al. Tissue-based coronary surgery simulation: medical student deliberate practice can achieve equivalency to senior surgery residents. J Thorac Cardiovasc Surg. 2013;145(6):1453–9.CrossRefPubMed
16.
Zurück zum Zitat Grober ED, Hamstra SJ, Wanzel K, Reznick RK, Matsumoto ED, Sidhu RS, et al. Laboratory-based training in urological microsurgery with bench model simulators: a randomized controlled trial evaluating the durability of technical skill. J Urol. 2004;172(1):378–81.CrossRefPubMed Grober ED, Hamstra SJ, Wanzel K, Reznick RK, Matsumoto ED, Sidhu RS, et al. Laboratory-based training in urological microsurgery with bench model simulators: a randomized controlled trial evaluating the durability of technical skill. J Urol. 2004;172(1):378–81.CrossRefPubMed
17.
Zurück zum Zitat Perez RS, Skinner A, Weyhrauch P, Niehaus J, Lathan C, Schwaitzberg SD, et al. Prevention of surgical skill decay. Mil Med. 2013;178(10 Suppl):76–86.CrossRefPubMed Perez RS, Skinner A, Weyhrauch P, Niehaus J, Lathan C, Schwaitzberg SD, et al. Prevention of surgical skill decay. Mil Med. 2013;178(10 Suppl):76–86.CrossRefPubMed
18.
Zurück zum Zitat Wilasrusmee C, Lertsithichai P, Kittur DS. Vascular anastomosis model: relation between competency in a laboratory-based model and surgical competency. Eur J Vasc Endovasc Surg. 2007;34(4):405–10.CrossRefPubMed Wilasrusmee C, Lertsithichai P, Kittur DS. Vascular anastomosis model: relation between competency in a laboratory-based model and surgical competency. Eur J Vasc Endovasc Surg. 2007;34(4):405–10.CrossRefPubMed
19.
Zurück zum Zitat Dreyfus SE, Dreyfus HL. A five-stage model of the mental activities involved in directed skill acquisition. Berkeley: California Univ Operations Research Center; 1980.CrossRef Dreyfus SE, Dreyfus HL. A five-stage model of the mental activities involved in directed skill acquisition. Berkeley: California Univ Operations Research Center; 1980.CrossRef
20.
Metadaten
Titel
Introducing off-the-job training to cardiovascular surgical residency training: a new era of developing competent cardiovascular surgeons
verfasst von
Hitoshi Yokoyama
Publikationsdatum
07.12.2018
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 4/2019
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-018-1747-3

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