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Hands-on 2.0: improving transfer of training via the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Acquisition of Data for Outcomes and Procedure Transfer (ADOPT) program

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Abstract

Background

Practicing surgeons commonly learn new procedures and techniques by attending a “hands-on” course, though trainings are often ineffective at promoting subsequent procedure adoption in practice. We describe implementation of a new program with the SAGES All Things Hernia Hands-On Course, Acquisition of Data for Outcomes and Procedure Transfer (ADOPT), which employs standardized, proven teaching techniques, and 1-year mentorship. Attendee confidence and procedure adoption are compared between standard and ADOPT programs.

Methods

For the pilot ADOPT course implementation, a hands-on course focusing on abdominal wall hernia repair was chosen. ADOPT participants were recruited among enrollees for the standard Hands-On Hernia Course. Enrollment in ADOPT was capped at 10 participants and limited to a 2:1 student-to-faculty ratio, compared to the standard course 22 participants with a 4:1 student-to-faculty ratio. ADOPT mentors interacted with participants through webinars, phone conferences, and continuous email availability throughout the year. All participants were asked to provide pre- and post-course surveys inquiring about the number of targeted hernia procedures performed and related confidence level.

Results

Four of 10 ADOPT participants (40%) and six of 22 standard training participants (27%) returned questionnaires. Over the 3 months following the course, ADOPT participants performed more ventral hernia mesh insertion procedures than standard training participants (median 13 vs. 0.5, p = 0.010) and considerably more total combined procedures (median 26 vs. 7, p = 0.054). Compared to standard training, learners who participated in ADOPT reported greater confidence improvements in employing a components separation via an open approach (p = 0.051), and performing an open transversus abdominis release, though the difference did not achieve statistical significance (p = 0.14).

Discussion

These results suggest that the ADOPT program, with standardized and structured teaching, telementoring, and a longitudinal educational approach, is effective and leads to better transfer of learned skills and procedures to clinical practice.

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Acknowledgements

The authors would like to acknowledge the leaders of the Lapco TT program, colorectal surgical consultants Mark Coleman and Tom Cecil, and research fellow Susannah Wyles, for bringing this revolutionary mentor training program to the USA, training the authors as instructors (JD, JP, BD), and their time, energy, support, and expertise in participating in the training of the course mentors. The authors also wish to thank our world-class surgeon mentors for their enthusiasm, expertise, and time commitment: Drs. William Cobb, William Hope, Mike Liang, Archana Ramaswamy, Shawn Tsuda, and Khashayar Vaziri.

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Authors and Affiliations

  1. Inova Fairfax Medical Campus, Falls Church, VA, USA

    Jonathan Dort & Amber Trickey

  2. LSU Health New Orleans School of Medicine, New Orleans, LA, USA

    John Paige

  3. SAGES, Los Angeles, CA, USA

    Erin Schwarz

  4. Houston Methodist, Houston, TX, USA

    Brian Dunkin

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  1. Jonathan Dort
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  2. Amber Trickey
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Corresponding author

Correspondence to Jonathan Dort.

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Disclosures

Dr. Dort is the Co-Chairman of the Quality, Outcomes, and Safety Committee of SAGES. Dr. Paige receives grant support from HRSA, LSU Board of Regents, Acell, Inc., and Intuitive, Inc., and receives royalties from Oxford University Press. He is also the Chairman of the Continuing Medical Education Committee of SAGES. Ms. Schwarz provides consulting services on behalf of the association management firm, BSC Management, for SAGES. Dr. Dunkin is the Past President of SAGES. Jonathan Dort, Amber Trickey, John Paige, Erin Schwarz and Brian Dunkin have no conflicts of interest or financial ties relevant to the study.

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Dort, J., Trickey, A., Paige, J. et al. Hands-on 2.0: improving transfer of training via the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Acquisition of Data for Outcomes and Procedure Transfer (ADOPT) program. Surg Endosc 31, 3326–3332 (2017). https://doi.org/10.1007/s00464-016-5366-z

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  • DOI: https://doi.org/10.1007/s00464-016-5366-z

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