Training Surgeons for Rectal Cancer Surgery: Clinical and Simulation

Abstract

Rectal cancer surgery is complex, high stakes and is especially difficult to learn. This is due to the complex anatomy, rapid progression of technology and absolute necessity for optimal clinical and oncological outcomes. More often than not it is learnt within a traditional apprenticeship model, which is unsatisfactory. To overcome these difficulties educational principles must be used in conjunction with various training modalities. Cognitive training and virtual reality, animal and cadaveric simulation is necessary to climb the early part of the learning curve before operating on patients. Once in the operating room, interactive assistance, modular training and appropriate case selection ought to be combined to enhance the training experience whilst prioritizing patient safety. Competency based training progression has to be monitored and final competency demonstrated by assessment of operative videos and pathological specimens. Rectal cancer surgical training should occur in high volume centers of excellence with adequate volume, finances and appropriately trained faculty. This will result is a competency based, comprehensive, multimodal, multifocal and multi-site training program aimed at training high quality rectal surgeons whilst safeguarding patients.