Pediatric Surgical Education Research Articles

Social media: The forefront of pediatric surgical education, recruitment, and information

BackgroundThe use of social media and mobile applications in surgery has grown exponentially over the past decade with a wide array of functions ranging from surgical education, recruitment to training programs, and improving the ability to share clinical information. It behooves surgical training programs and pediatric surgeons to engage in social media as the modern surgical trainee is learning and networking on a professional level through social media platforms on their mobile devices. MethodsThis is a retrospective analysis of social media analytics from a single general surgery residency program as well as an online pediatric surgery educational resource, StayCurrentMD. Social media followers were stratified by age groups. Furthermore, we summarize the various uses for social media and mobile applications for surgical trainees and pediatric surgeons. ResultsThe StayCurrentMD social media followers from Facebook, Instagram, TikTok, and YouTube included 10,218 total followers and the Wright State University General Surgery Residency had 2,066 followers from Facebook and Instagram. The age group for most followers was 25–34 years of age for all social media platforms except for Facebook which had slightly higher proportions of followers in the 35–44 age group. ConclusionThe modern medical student does not learn about training programs from in-person interviews and today's surgical trainee is no longer in the library to read about surgical technique or current practice guidelines – they're on their phones. Surgical training programs, surgical societies, and surgical educators of the world need to adapt to these changes in technology to improve surgical education and distribute information to surgical providers on a potentially global scale.

Development and assessment of a simulation-based curriculum in pediatric surgical education: Conventional wisdom and lessons learned from the national training program in France

Traditional training in pediatric surgery has focused on knowledge acquisition and technical skills. Although recognized as important, the skills relating to communication, collaboration, leadership, management, health advocacy and professionalism have received less formal attention. Recognition of the importance of these softer skills in combination with the greater use of simulation in education prompted us to develop a national simulation-based curriculum in pediatric surgery. This paper describes the development, implementation and three-year follow-up of the mandatory, simulation-based curriculum for pediatric surgery residents in France. We review the available literature on the topic and present our results.

Performance assessment - The knowledge, skills and attitudes of surgical performance

Pediatric surgical education has traditionally focused on the hard cognitive and psychomotor (technical) skills. While more and more attention is being paid to softer skills such as communication, collaboration, leadership, health advocacy, professionalism and scholarship, the bulk of curricula remain focused on the hard skills. An intricate part of education is the assessment of performance. This article reviews the current literature on the assessment of cognitive and psychomotor skills, focusing particularly on the assessment of technical skills in the realm of simulation.

Paediatric cardiac surgical education: which are the important elements?

Pediatric cardiac surgical education and the associated requirements for certification vary considerably from one country to another. Evolution and standardization for pediatric cardiac surgical education may not have kept pace with the evolution of other aspects of the specialty. Restriction of work hours and disqualification of foreign training experience constitute potential threats to our specialty. A global strategy for qualification and certification may help to address some of these difficult issues.

Preliminary Evaluation of a Laparoscopic Common Bile Duct Simulator for Pediatric Surgical Education.

Laparoscopic common bile duct exploration (LCBDE) decreases overall costs and length of stay in patients with choledocolithiasis. However, utilization of LCBDE remains low. We sought to evaluate a previously developed general surgery LCBDE simulator among a cohort of pediatric surgical trainees. The study purpose was to evaluate the content validity of an LCBDE simulator to support or refute its use in pediatric surgery education. After IRB exempt determination, 30 participants performed a transcystic LCBDE using a previously developed simulator and evaluated the simulator using a self-reported 28-item instrument. The instrument consisted of two primary domains (Quality and Ability to Perform) that were rated using twenty-five 4-point rating scales and one 4-point global rating scale. Validity evidence relevant to test content was evaluated using a many-facet Rasch model. Interitem consistency was estimated using Cronbach's alpha. P < .05 was considered statistically significant. The highest combined observed averages were for the Value subdomain (OA = 3.79), whereas the lowest ratings were for the Physical/visual attributes subdomain (OA = 3.19). The averaged global rating was 3.14, consistent with this simulator can be considered for use in pediatric LCBDE training, but could be improved slightly. Rasch indices were favorable and supported evidence relevant to test content. Interitem consistency estimates were also favorable, with α values of 0.94 and 0.56 for Qualities and Ability, respectively. Overall, participants rated the LCBDE simulator highly valuable for pediatric surgical education and felt that it could be used as an educational tool with minor modifications.

Advances in Pediatric Surgical Education: A Critical Appraisal of Two Consecutive Minimally Invasive Pediatric Surgery Training Courses.

Mandates for improved patient safety and increasing work hour restrictions have resulted in changes in surgical education. Educational courses increasingly must meet those needs. We sought to determine the experience, skill level, and the impact of simulation-based education (SBE) on two cohorts of pediatric surgery trainees. After Institutional Review Board (IRB) exempt determination, a retrospective review was performed of evaluations for an annual advanced minimally invasive surgery (MIS) course over 2 consecutive years. The courses included didactic content and hands-on skills training. Simulation included neonatal/infant models for rigid bronchoscopy-airway foreign body retrieval, laparoscopic common bile duct exploration, and real tissue diaphragmatic hernia (DH), duodenal atresia (DA), pulmonary lobectomy, and tracheoesophageal fistula models. Categorical data were analyzed with chi-squared analyses with t-tests for continuous data. Participants had limited prior advanced neonatal MIS experience, with 1.95 ± 2.84 and 1.16 ± 1.54 prior cases in the 2014 and 2015 cohorts, respectively. The 2015 cohort had significantly less previous experience in lobectomy (P = .04) and overall advanced MIS (P = .007). Before both courses, a significant percentage of participants were not comfortable with DH repair (39%-42%), DA repair (50%-74%), lobectomy (34%-43%), and tracheoesophageal fistula repair (54%-81%). After course completion, > 60% of participants reported improvement in comfort with procedures and over 90% reported that the course significantly improved their perceived ability to perform each operation safely. Pediatric surgery trainees continue to have limited exposure to advanced MIS during clinical training. SBE results in significant improvement in both cognitive knowledge and trainee comfort with safe operative techniques for advanced MIS.

Design and development of a laparoscopic gastrostomy tube placement simulator.

Laparoscopic gastrostomy tube placement is a common surgical procedure performed in infants. There are currently no commercially available simulation tools for pediatric surgeons to use for surgical training and practice purposes. We have created a low cost and reusable laparoscopic gastrostomy tube placement model for use in pediatric surgical education.

Innovation in Pediatric Surgical Education for General Surgery Residents: A Mobile Web Resource

General surgery residents lack a standardized educational experience in pediatric surgery. We hypothesized that the development of a mobile educational interface would provide general surgery residents broader access to pediatric surgical education materials. We created an educational mobile website for general surgery residents rotating on pediatric surgery, which included a curriculum, multimedia resources, the Operative Performance Rating Scale (OPRS), and Twitter functionality. Residents were instructed to consult the curriculum. Residents and faculty posted media using the Twitter hashtag, #UCLAPedSurg, and following each surgical procedure reviewed performance via the OPRS. Site visits, Twitter posts, and OPRS submissions were quantified from September 2013 to July 2014. The pediatric surgery mobile website received 257 hits; 108 to the homepage, 107 to multimedia, 28 to the syllabus, and 19 to the OPRS. All eligible residents accessed the content. The Twitter hashtag, #UCLAPedSurg, was assigned to 20 posts; the overall audience reach was 85 individuals. Participants in the mobile OPRS included 11 general surgery residents and 4 pediatric surgery faculty. Pediatric surgical education resources and operative performance evaluations are effectively administered to general surgery residents via a structured mobile platform.

Collaboration in Pediatric Surgical Training &amp; Education among Asian Countries &amp; Beyond –Bangladesh perspective

Abstract not availableJ. Paediatr. Surg. Bangladesh 3(2): 54-55, 2012 (July)

The role of new information technology meeting the global need and gap of education in pediatric surgery

Traditionally, pediatric surgical education consisted of exposure to patients, textbooks, lectures, team-based education, congresses, and workshops. Over the last decades, however, new information technology (IT) and the internet revolutionized the sharing of information and communication. IT has become relevant in particular for the younger generation of pediatric surgeons. Today, gaps in children׳s health and the quality of pediatric surgical education persist between countries and regions. Advances in health care are not shared equitably. The use of IT for resource libraries, teleconferences, virtual symposiums, and telementoring has great potential in closing this gap and meeting the global needs for pediatric surgical education. This article focuses on the potential role of IT in this respect.

Modern, multi-media, advances in surgical information

The need for education does not end with residency. Practicing surgeons must find ways to stay current. The boom in new technologic developments may significantly enhance our methods of teaching through the use of new mutli-media. Here we will explore some of the muti-media innovations that have or may have the greatest impact on surgical education. Live, interactive, and online forums have proven to be effective new methods of bringing people together to discuss and learn new concepts in medicine. These forums allow physicians to interact with key opinion leaders and flatten knowledge sharing, so that everyone may have a voice. The dynamic, fast paced, and interactive format allows for screen-based learning to be engaging and interactive. Information is now available online in multiple formats that are continuously updated, so that information is no longer outdated by the time it is published in a textbook. Multi-media is now being used to disseminate content through, archived video, live video, as well as audiocasts. All of these are creating more modern ways for physicians to stay up-to-date either at home, in the office, or when mobile. Lastly, new advanced, interactive, technology can allow experts to assist less-experienced surgeons as “virtual partners” through telementoring. With telementoring, an expert can be virtually present while another surgeon is performing a complex, new, operation, and the expert can help with voice suggestions and on-screen telestration. Pediatric surgical education has made a giant leap thanks to new developments in multi-media technology.

Innovation in pediatric surgical education

Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.

Pediatric surgical camps as one model of global surgical partnership: A Way Forward

Background/PurposeA uniquely Ugandan method of holding surgical “camps” has been one means to deal with the volume of patients needing surgery and provides opportunities for global partnership. MethodsWe describe an evolved partnership between pediatric surgeons in Uganda and Canada wherein Pediatric Surgical Camps were organized by the Ugandans with team participation from Canadians. The camp goals were to provide pediatric surgical and anesthetic service and education and to foster collaboration as a way forward to assist Ugandan health delivery. ResultsThree camps were held in Uganda in 2008, 2011, and 2013. A total of 677 children were served through a range of operations from hernia repair to more complex surgery. The educational mandate was achieved through the involvement of 10 Canadian trainees, 20 Ugandan trainees in surgery and anesthesia, and numerous medical students. Formal educational sessions were held. The collaborative mandate was manifest in relationship building, an understanding of Ugandan health care, research projects completed, agreement on future camps, and a proposal for a Canadian–Ugandan pediatric surgery teaching alliance. ConclusionPediatric Surgical Camps founded on global partnerships with goals of service, education, and collaboration can be one way forward to improve pediatric surgery access and expertise globally.

Evolving Techniques in Pediatric Surgical Education

Evolving Techniques in Pediatric Surgical Education

Pediatric surgical training: An historic perspective, a formula for change

Background/purpose American pediatric surgical education has more than a 65-year history of formalizing the organization and the curriculum of the training process. However, never before have so many simultaneous internal and external forces appeared on the horizon that have the collective potential of influencing the quality of future pediatric surgeons. It is the purpose of this study to identify and detail these opportunities, compare them with the historical past, and propose the beginnings of a strategy to control the destiny. The ultimate goal should be to continue to assure that pediatric surgeons are of the highest attainable quality that will optimize the surgical health of America’s children. Methods and results Using a current literature review, 7 specific influencing forces have been identified: a declining applicant pool, the generation-X factor, medical economics, early specialization of training, restricted residency work hours, pediatric surgical manpower, and competency-based surgical education. An effective response to these forces is multifactorial, but a first need might be consideration of a new educational oversight organizational structure for pediatric surgery. Thereafter, specific curricular reform is needed to match the strengths of the candidates as well as the training programs. Finally, as a specialty field we must assert the leadership needed to define optimal educational outcomes. Conclusions This report defines the educational history and the contemporary influencing forces, and it proposes a strategy to assure that pediatric surgical education exceeds the needs of America’s children into the future.

Declaration of pediatric surgery

The World Federation of Associations of Pediatric Surgeons (WOFAPS) is an International organization whose membership is comprised of national pediatric surgical associations from more than 70 countries. The purpose of the WOFAPS is to promote the delivery of quality surgical care to infants and children throughout the world. After a careful assessment of available pediatric surgical care, education and concepts regarding training of children's surgeons obtained from each of the member associations, the WOFAPS has developed a consensus statement regarding the nature of the specialty and recommended a set of guidelines for children's surgical care. The Executive Council of WOFAPS met in Kyoto, Japan on May 3, 2001 and unanimously endorsed the following Declaration of Pediatric Surgery.

An analysis of the operative experience of North American pediatric surgical training programs and residents

There has been a rapid increase in the number of pediatric surgical training programs. To meet the goals of quality patient care and surgical education, training and practice activities must be objectively monitored. The aim of this study was to collect and analyze the experience of American and Canadian Pediatric Surgical training centers and residents. The authors collected the 1-year operative experience of 31 American and six Canadian training programs and the 2-year operative experience of the 25 most recently graduated residents. Categories analyzed included total cases, defined categories (neonatal, important, and tumor cases), routine cases, thoracic, cardiac, urologic reconstructive, head and neck, endoscopy, vascular, plastics and burn procedures. From these data six assumptions about the training in pediatric surgery were addressed. (1) The operative activity of the United States and Canadian training programs and residents are comparable. The results show that there are few major differences in operative experience. (2) There should be variability in operative experience between programs but little variability between residents. The North American operative experience for both residents and institutions are marked by high variability and leftward shift in the frequency distributions. (3) A resident's training should consist of a significant portion of “index cases” and fewer routine cases. The residents perform 28% of their total cases in the three defined categories (index cases) and 26% as routine cases. (4) Pediatric surgeons are the true general surgeons, performing operations in areas such as cardiac, reconstructive genitourinary, plastic, and burn surgery. Examination of the data shows that most programs and residents perform few cases in these four areas. (5) Certain procedures such as thoracic, genitourinary, vascular, head and neck, and endoscopy remain within the domain of pediatric surgery. The results show that this assumption is true for thoracic, vascular, head and neck, and endoscopy but not for genitourinary, and there is wide variability between institutions and between residents. (6) “Core” pediatric surgical conditions such as esophageal atresia, biliary atresia, and intersex are still available in significant numbers to train residents. The data show that a surprising number of programs and residents perform few or none of the core operations. This analysis is the first step toward monitoring of pediatric surgical resident education. A future study is underway to evaluate the current experience of practicing pediatric surgeons who have taken the recertification examination.

Pediatric Surgical Education for Students and Postgraduates at Children&apos;s Hospitals in Japan

Pediatric Surgical Education for Students and Postgraduates at Children&apos;s Hospitals in Japan