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Authors: Huber, Tobias
Richardsen, I.
Klinger, C.
Mille, M.
Roeth, A. A.
Dörner, Johannes
Drewes, Sebastian
Fabig, Stefan
Gaedcke, Jochen
Günter, Patricia J.
Jauch, Dominik
Koch, Franziska
Lenzen, Jana
Obst, Marianne
Orthaus, Ulrike
Schacke, Vivien
Schassen, Christian von
Scheurer, Laura
Schmitz, Sophia
Scholtes, Ben
Schreier, Johanna
Sommer, Nils P.
Uhlmann, Dirk
Wobith, Maria
Zaczek, Michael
Title: See (n)one, do (n)one, teach (n)one : reality of surgical resident training in Germany
Online publication date: 21-Jun-2021
Language: english
Abstract: INTRODUCTION Due to technological changes, working time restrictions and the creation of specialized centers, surgical training has changed. A competence-based learning technique of surgical skills is the sub-step practice approach, which has been proven important in nationwide opinion surveys. The aim of this prospective multi-center trial was to determine the status quo of the sub-step concept in Germany. METHODS Over 6 months, the voluntarily participating centers evaluated the following index procedures: laparoscopic cholecystectomy (LCHE), laparoscopic and open sigmoid resection, minimally invasive inguinal hernia repair, thyroid resection and pylorus-preserving pancreaticoduodenectomy (PPPD). Patients with private insurance were excluded. The detailed sub-steps were documented as well as the reason why these were not performed. In addition, an online survey regarding the sub-step concept was performed before and after the study. RESULTS In total, 21 centers included 2969 surgical procedures in 2018 for final analyses. While 24.4% of the procedures were performed by residents, sub-steps were performed in 22.2%. LCHE was most often performed completely by residents (43.3%), and PPPD revealed the highest rate of performed sub-steps (43.3%). Reasons for not assisting sub-steps to residents were often organizational and other reasons. After an initial increase, the number of performed sub-steps decreased significantly during the second half of the survey. The opinion survey revealed a high importance of the sub-step concept. The number of resident procedures was overestimated, and the number of performed sub-steps was underestimated. After the study, these estimations were more realistic. CONCLUSION Even though the sub-step practice concept is considered highly important for surgical education, it needs to be put into practice more consequently. The current data suggest a low participation of surgical residents in the operating room, although the participating hospitals are most likely highly interested in surgical education, hence their voluntary participation. Conceptual changes and a control of surgical education are needed.
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY
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Journal: World journal of surgery
Pages or article number: 2501
Publisher: Springer
Publisher place: New York, NY
Issue date: 2020
ISSN: 1432-2323
Publisher URL:
Publisher DOI: 10.1007/s00268-020-05539-6
Appears in collections:JGU-Publikationen

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