Surg J R Coll Surg E
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Skills training has been an increasingly important focus of surgical training and is ideally performed prior to reaching the operating room. Although our understanding of the role is increasing, and there are more publications describing endpoints with simulation and different training models, the optimal training methodology remains unclear. ⋯ Feedback during training is likely important, and the more proximate that feedback, the better its effectiveness. Optimal skills' training likely depends on a combination of having the optimal curriculum, in conjunction with an appropriate training model.
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Objective assessment of technical skill is an important component of skills training: trainees require that deficiencies are clearly and objectively identified if a model of deliberate practice with feedback on skill acquisition is to be employed. There are several types of reliable and valid assessments for technical skill currently available.
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Major imperatives regarding quality of patient care and patient safety are impacting surgical care and surgical education. Also, significant emphasis continues to be placed on education and training to achieve proficiency, expertise, and mastery in surgery. Simulation-based surgical education and training can be of immense help in acquiring and maintaining surgical skills in safe environments without exposing patients to risk. ⋯ New education and training models involving validation of knowledge and skills are being designed for practicing surgeons. A competency-based national surgery resident curriculum was recently launched and is undergoing further enhancements to address evolving education and training needs. Innovative simulation-based surgical education and training should be offered at state-of-the-art simulation centers, and credentialing and accreditation of these centers are key to achieving their full potential.
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The delivery of healthcare is undergoing a major transition period across the globe. Drivers for change range from the introduction of new technologies such as primary angioplasty and robotic surgery, to restriction in work hours of trainee doctors.
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The education, certification, and credentialing of surgeons is undergoing change brought about by public expectations and by reform within the profession. In the United States, there is a clear trend towards standardization of education, as exemplified by the Surgical Council on Resident Education (SCORE) curriculum. ⋯ Finally, there is clarity emerging from the curriculum development process about the expected operative skills of graduating surgical trainees, and this will ultimately drive the process by which surgeons are credentialed by their hospitals or surgical centers. This period of change is being accompanied by a demand for more assessment of trainees and for outcomes-based training and residency program accreditation.