Surg J R Coll Surg E
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Surg J R Coll Surg E · Jan 2011
ReviewUse of the operative logbook to monitor trainee progress, and evaluate operative supervision provided by accredited training posts.
The Surgical Education and Training (SET) program of the Royal Australasian College of Surgeons (RACS) represents a change from a time-based program to a competency-based program and much greater emphasis is placed on formative assessment and timely feedback (to Surgical Training Boards - STBs - as well as to the trainee). It demands early recognition of the trainee who is struggling to progress, the so-called "marginal trainee". ⋯ SET also places a demand on training posts--with the expectation that they are providing an environment that is conducive to learning and that the trainees are getting adequate learning opportunities. In the domain of operative skills, this largely implies that levels of operative teaching and supervision should be appropriate to the trainee's stage and ability.
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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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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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Surg J R Coll Surg E · Jan 2011
ReviewWorkplace-based assessment: the need for continued evaluation and refinement.
Workplace-Based Assessment (WBA) has been an integral part of the UK Intercollegiate Surgical Curriculum Programme (ISCP) since 2007 (www.iscp.ac.uk). The UK Postgraduate Medical Education and Training Board (now part of the General Medical Council) has defined WBA as 'the assessment of working practices based on what trainees actually do in the workplace, and predominantly carried out in the workplace itself' (www.gmc.org.uk). This article reviews the purpose of WBA and the methods in current use. It also discusses the misuse of WBA and possible solutions, including redesign of the rating scales.