Hand Surgery Training Structure in Germany - Evaluation of an Online Questionnaire

Abstract

The duration of the training for hand surgery in Germany was reduced from three to two years in 2020, while other European Countries introduced hand surgery as a separate surgical specialty. Therefore, the structure of hand surgery training in Germany is under intense, ongoing discussion. This study aimed to evaluate the current situation of hand surgery training in Germany. Two separate online questionnaires were developed for self-assessment of residents and teachers in German hand surgery services. The questionnaire contained 29 questions for residents and 24 questions for teachers. Demographic data, educational tools, surgical training parameters and satisfaction were assessed from May to July 2023. The survey was based on the former training time of three years. The online questionnaire was sent to the members and associate members of the German Society for Hand Surgery via email. 148 participants answered the questionnaire, including 54 residents and 94 teachers. Overall, more female residents were assessed, whereas the majority of teachers was male. Hand surgery training is mostly conducted in high-level hospitals (tertiary care p=0.012, quaternary care p<0.001). Residents use digital teaching media significantly more often than teachers do (p<0.001). In contrast, teachers use journals (p=0.006) and clinical visits (p=0.024) significantly more often for their training than residents do. Trainers and trainees mostly agreed about time points of surgical milestones during surgical training that should be performed independently. Both trainers and trainees were largely satisfied with the practical and theoretical training in hand surgery. The importance of digital media in hand surgery training will increase in the near future. Therefore, digital media should be more frequently included in hand surgery training protocols. The study revealed that the majority of residents as well as teachers would appreciate the introduction of an independent hand surgery specialty, which would most likely improve the hand surgery competence in Germany.