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Introducing off-the-job training to cardiovascular surgical residency training: a new era of developing competent cardiovascular surgeons

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Abstract

Purpose

This review summarizes the recent progress made in understanding the skill acquisition process of achieving expert status in various fields that require fine motor skills. We discuss the attempts to apply this progress to develop competent surgeons.

Methods

We reviewed the existing literature, using the keywords “surgical training”, “skill acquisition”, and “simulator-based training”, using Medline, as well as recent books and chapters related to these issues. We also summarized the role of simulator-based training in basic skill acquisition through deliberate practice. Other aspects of surgical skills, such as steps taken to improve motor skills, technical skill in the operating room, and competency level from novice to expert, were reviewed.

Results

The common element of practice to develop top-ranking experts in various fields is deliberate practice. Long-term repetitive practice is supported by the individual’s mental attitude: guts, resilience, initiative, tenancy (GRIT). GRIT can be imparted using a teaching method that supports a “growth mindset”.

Conclusions

Recent theoretical advances in skill acquisition can be applied to surgical residency training, while intense efforts are being made to improve the curriculum and training environment.

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References

  1. Carter BN. The fruition of Halsted’s concept of surgical training. Surgery. 1952;32:518–27.

    CAS  PubMed  Google Scholar 

  2. Reznick RK, Macrae H. Teaching surgical skills—changes in the Wind. N Engl J Med. 2006;355:2664–9.

    Article  CAS  PubMed  Google Scholar 

  3. Fitts PM, Posner MI. Human performance. Belmont: Brooks/Cole Pub.; 1967.

    Google Scholar 

  4. Hamdorf JM, Hall JC. Acquiring surgical skills. Br J Surg. 2000;87:28–37.

    Article  CAS  PubMed  Google Scholar 

  5. Ericsson KE. Peak: how to master almost anything. New York: Viking Press; 2016.

    Google Scholar 

  6. Ericsson KE, Charness N, Feltovich PJ, Hoffman RR. The Cambridge handbook of expertise and expert performance. New York: Cambridge university press; 2006.

    Book  Google Scholar 

  7. Duckworth A. Grit. The power of passion and perseverance. New York: Scribner; 2016.

    Google Scholar 

  8. Dweck CS. Mindset: the new psychology of success. New York: Ballantine Books; 2007.

    Google Scholar 

  9. Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C,et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg. 1997;84:273–8.

    Article  CAS  PubMed  Google Scholar 

  10. Birkmeyer JD, Finks JF, O`Reilly A, Oerline M, Carlin AM, Nunn AR, et al. Surgical skill and complication rates after bariatric surgery. N Engl J Med. 2013;369(15):1434–42.

    Article  CAS  Google Scholar 

  11. De Raet JM, Arroyo J, Büchner S, Siregard S, Andreas M, Halvorsen F, et al. How to build your own coronary anastomosis simulator from scratch. Interact Cardiovasc Thorac Surg. 2013;16(6):772–6.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Park Y, Yokoyama H. Simulator for surgical training. Kyobu-geka. 2018;71(10):779–87.

    PubMed  Google Scholar 

  13. Price J, Naik V, Boodhwani M, Brandys T, Hendry P, Lam BK. A randomized evaluation of simulation training on performance of vascular anastomosis on a high-fidelity in vivo model: the role of deliberate practice. J Thorac Cardiovasc Surg. 2011;142(3):496–501.

    Article  PubMed  Google Scholar 

  14. Zilbert NR, St-Martin L, Regehr G, Gallinger S, Moulton CA. Planning to avoid trouble in the operating room: experts’ formulation of the preoperative plan. J Surg Educ. 2015;72(2):271–7.

    Article  PubMed  Google Scholar 

  15. Nesbitt JC, St Julien J, Absi TS, Ahmad RM, Grogan EL, Balaguer JM, et al. Tissue-based coronary surgery simulation: medical student deliberate practice can achieve equivalency to senior surgery residents. J Thorac Cardiovasc Surg. 2013;145(6):1453–9.

    Article  PubMed  Google Scholar 

  16. Grober ED, Hamstra SJ, Wanzel K, Reznick RK, Matsumoto ED, Sidhu RS, et al. Laboratory-based training in urological microsurgery with bench model simulators: a randomized controlled trial evaluating the durability of technical skill. J Urol. 2004;172(1):378–81.

    Article  PubMed  Google Scholar 

  17. Perez RS, Skinner A, Weyhrauch P, Niehaus J, Lathan C, Schwaitzberg SD, et al. Prevention of surgical skill decay. Mil Med. 2013;178(10 Suppl):76–86.

    Article  PubMed  Google Scholar 

  18. Wilasrusmee C, Lertsithichai P, Kittur DS. Vascular anastomosis model: relation between competency in a laboratory-based model and surgical competency. Eur J Vasc Endovasc Surg. 2007;34(4):405–10.

    Article  CAS  PubMed  Google Scholar 

  19. Dreyfus SE, Dreyfus HL. A five-stage model of the mental activities involved in directed skill acquisition. Berkeley: California Univ Operations Research Center; 1980.

    Book  Google Scholar 

  20. Benner P. From novice to expert. Menlo Park: Addison-Wesley; 1984.

    Book  Google Scholar 

  21. Grantcharov TP, Reznick RK. Teaching procedural skills. BMJ. 2008;336:1129–31.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We thank Dr. Kazuo Tanemoto, the Director of Executive Council, and the Japanese Board of Cardiovascular Surgery for providing the results of a questionnaire distributed to the examinees of the Japanese Board of Cardiovascular Surgeons.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, 960-8072, Japan

    Hitoshi Yokoyama

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  1. Hitoshi Yokoyama
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Correspondence to Hitoshi Yokoyama.

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Hitoshi Yokoyama has no conflicts of interest to declare.

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Yokoyama, H. Introducing off-the-job training to cardiovascular surgical residency training: a new era of developing competent cardiovascular surgeons. Surg Today 49, 300–310 (2019). https://doi.org/10.1007/s00595-018-1747-3

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