An Assessment of the Continuing Surgical Education Program, a Surgical Preceptor Program for Faculty Members.

Abstract

The Continuing Surgical Education Preceptor program (CSEP) was designed to meet population needs by facilitating development of new skills by practising surgeons. Elements include entry criteria, dedicated OR time, assigned preceptors, structured assessment of competence, a mechanism for credentialing, and a reimbursement model. This study analyzed the effectiveness of the CSEP in increasing the number of clinician educators performing laparoscopic hysterectomy (LH) without compromising rates of vaginal hysterectomy (VH) and in enhancing residents' training in performing minimally invasive hysterectomy (MIH; either LH or VH). We performed a retrospective descriptive study to longitudinally analyze the numbers and proportions of different surgical approaches to hysterectomy at two hospital sites over five years. The CSEP was implemented differently at the two sites. Success of the program was indicated by a surgeon performing 50% or more of hysterectomies as MIH. To assess the impact on resident education, we longitudinally analyzed the number of hysterectomy teaching cases performed as MIH. The proportion of surgeons performing 50% of hysterectomies as MIH steadily increased in the first five years after implementation of the CSEP. At one hospital, the proportion increased from 13% to 56%, due to an increase in LH cases with no change in VH cases. The proportion of resident LH teaching cases increased from 0% to 26%, with a similar rise in the proportion of MIH cases, although it did not quite reach the target proportion of 50% or more. Contrasting the experience of the CSEP between two hospitals revealed that having OR time dedicated to MIH cases provided significantly better results. The CSEP is an effective and sustainable model of lifelong learning applied to teaching practising surgeons new surgical skills.