Deconstructing operations to improve recording of surgical training experience for the new curriculum

Abstract

Surgical training in the UK has become outcomes-based with the implementation of the new curriculum. Performance is evaluated against the standard expected of a new consultant. Accurate recording of operative experience and performance is necessary to demonstrate achievement of this standard. The current eLogbook system for recording surgical experience is a significant improvement over paper-based records but may misrepresent actual experience because operations are considered as a whole; involvement in steps within many operations cannot be recorded. We describe how surgical training logbooks, such as eLogbook, can be improved by using an existing typology to deconstruct operations into steps, using a worked example. Trainees will gain the ability to record their experience of operations and simulations in considerably more detail. It will be particularly useful in recording complex operations, which trainees are not expected to complete in their entirety. Less experienced trainees will benefit from being able to record their involvement in more basic parts of operations. We also propose integrating a component-based training discussion in the surgical team brief and debrief to complement the deconstructed logbook by promoting a training culture. The suggested approach may reduce misrepresentation of experience, encourage proactive planning of training opportunities and reduce the impact of crises such as the COVID-19 pandemic on surgical training.