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Year: 2019
Type: article
Abstract: Various pedagogical models have been introduced in an attempt to improve and restructure surgical training, but significant obstacles remain.Before implementing national guidelines, it is critical to explore residents' opinions to ensure a successful transition that meets their needs and addresses the challenges of reformatting surgical residency.This study aimed to establish a nationwide Delphi consensus statement on the opinions and perceptions of Canadian residents regarding the future of general surgery training.Canadian general surgery resident representatives participated in a moderated semistructured focus group using the nominal group technique to discuss issues related to general surgery training across 3 domains: early subspecialization, competency-based medical education (CBME) and a transition-to-practice (TTP) period.Qualitative verbal data were transcribed, grouped into themes and synthesized into a list of recommendation statements.During an iterative Delphi survey, residents ranked each statement on a 5-point Likert scale in terms of agreement.The survey was terminated once consensus was achieved (≥ 2 survey rounds and internal consistency Cronbach's α ≥ 0.80).Sixty-six statements were synthesized by 16 members of the Canadian Association of General Surgeons Resident Committee.Forty-nine residents participated in the Delphi consensus achieved after 2 voting rounds (Cronbach's α = 0.93).Participants agreed that (a) residency should be remodelled to focus on achieving standardized competencies and milestones, based on residents' ability to meet specific measurable metrics; (b) early streaming should be offered after "core" milestones and competencies have been achieved; and (c) an explicit period should allow transition to independent practice with tailored rotations, greater autonomy, patient ownership and resident-run clinics.Ten barriers to CBME implementation were also identified.A nationwide consensus regarding the future of surgical training was established among current residents.These findings can help in the implementation of guidelines and new national curricula that meet trainees' needs and address the many challenges they face in their training.
Source: Canadian Journal of Surgery
DOI: 10.1503/cjs.011719
Authors: C. Huynh, E. Clement, D. DeGirolamo, A. Kleiman, R. Ralph-Edwards, L. Streith, J. Bogach, B. Zhang, J. Wang, C. Griffiths, M. Schellenberg, M. Schellenberg, M. Schellenberg, M. Schellenberg, N. Mookerji, L. Yang, E. Bilgic, J. Wang, E. Roach, T. Schroeder, A. Albarrak, J. Schendel, D. Zhang, A. Eksteen, R. Leung, F. Shariff, M. Lemke, T. Ziegler, J. Younan, K. Garber, G. Aldosary, P. Murphy, G. Olleik, E. Grose, S. Godzisz, L. Findlay-Shirras, S. Seidl, M. Meschino, M. Trepanier, R. Alam, M. Trepanier, H. Ahn, L. Glass, V. Pravong, N. Gawad, C. Garcia-Ochoa, N. Gawad, N. Gawad, K. Edwards, A. Tran, F. Dossa, J. Holden, G. Pang, E. Tang, A. Kirkpatrick, S. Alqahtani, M. Trust, H. Cheah, D. Lustig, F. Khazoom, T. Wong, D. Roberts, M. Nguyen, K. D’Souza, C. Way, D. Laczko, J. Beattie-Booth, L. Qu, A. Arora, K. Taqi, B. Giammarioli, S. Nanji, T. Wijayanayaka, T. McKechnie, T. Dumitra, L. Baker, E. Walser, C. Towaij, N. AlShahwan, M. Horkoff, M. Wiebe, B. Elsolh, M. Mohammed, T. Kuper, L. Abraham, N. Zondervan, M. Parapini, C. Gomez-Garibello, M. Lipson, A. Lalande, Z. Sagorin, S. Neri, S. Lo, G. Ko, A. Pang, R. Garfinkle, N. Wong-Chong, A. Black, J. Springer, J. Springer, A. Motamedi, R. Hajjar, N. Caminsky, A. Ni, L. Zhang, L. Zhang, M. Gagnon-Konamna, T. McKechnie, T. Almalki, M. Gagnon-Konamna, S. Al-Masrouri, S. Al-Masrouri, S. Al-Masrouri, C. Griffiths, M. Laffin, R. Gilbert, T. Dumitra, D. Yu, M. Dykstra, M. Boulianne, D. Jones, A. Pooni, F. Saleh, J. Rousseau, T. Khalid, V. Gupta, L. Donahoe, M. Bushra, M. Thivierge-Southidara, N. Safieddine, W. Sun, R. Malthaner, V. Resende, G. Sigler, D. Hylton, S. Shakeel, Y. Patel, E. MacKay, E. Goudie, N. Ahmadi, N. Ahmadi, N. Seyednejad, R. Ralph-Edwards, A. Kammili, H. Smith, V. Gupta, S. Gowing, V. Gupta, A. Chen, J. Cools-Lartigue, J. Mouhanna, A. Katz, R. Ben-Avi, Y. Shargall, S. Merchant, D. Mutabdzic, C. Yeo, J. Hallet, J. Hallet, D. Cyr, S. Luu, C. Huynh, N. Jedrzejko, E. Yee, R. Liu, A. Bazzarelli, S. Seidl, R. Tamblyn, P. Lovrics, E. Roach, A. Laws, M. Talbot, N. Coburn, G. Gauvin, D. Ng, J. Gu, L. Angka, S. Ollek, L. Meloche-Dumas, J. Levy, H. Li, D. Skubleny, S. Tung, J. Zuckerman, K. Purich, R. Liu, J. Grab, M. Driedger, L. Baker, Y. Wang, J. Levy, D. Henault, M. Al Khaldi, V. Zuk, C. Garcia-Ochoa, E. Theodosopoulos, L. Baker, Y. Essaji, L. Baker, Y. Essaji, E. Girard, A. MacDonald, J. Li, A. Connor, A. Connor, S. Manoharan, A. Drohan, F. Saleh, R. Bendavid, R. Bendavid, O. Lovrics, N. Ares Bruneau, S. Albacete, M. Moolla, S. Stogryn, S. Stogryn, N. Hanna, W. Sun, K. Bartellas, J. Dang, A. McLean, Z. Mir, J. Yu, R. Malhan, S. Seidl, D. Pace, H. Cheah, H. Cheah, B. Zevin, S. Skulsky, I. Tavakoli, J. Lee, A. Doumouras, S. Deghan Manshadi, V. Mocanu, M. El-Beheiry, N. Wong-Chong, P. Vourtzoumis, S. Lim, W. Marini, G. Johal, M. Strickland, A. Madani, A. Lee, A. Ericson, C. Gratton, J. Ryan, T. Clements, M. Kim, C. Ball, S. Widder, D. Hwang, B. Mador, S. Widder, B. Greenberg, M. 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Taqi, M. Martinka, N. Davis, A. McFadden, A. MacNeill, T. Hamilton, H. Stuart, A. Christopoulos, T. Ayad, R. Younan, A. Kaviani, K. Boulva, M. Liberman, A.-A. Bernard, J. Beaulieu, P. Borduas, N. El Sayed, X. Ma, E. Sédillot, É. Patocskai, V. Gupta, C. Allen-Ayodabo, E. Amirazodi, N. Jivraj, Q. Li, A. Mahar, O. Saarela, C. De Mestral, N. Coburn, B. Dingley, O. Brandts-Longtin, J. Dobransky, L. Baker, C. Nessim, E. Boivin, S. Bhavanam, S. Garg, R. McLean, M. McCall, D. Schiller, G. Rayat, N. Coburn, L. Davis, A. Mahar, S. Myrehaug, H. Zhao, C. Earle, A. Nathens, J. Hallet, A. Gorgen, S. Acuña, N. Goldaracena, M. Cattral, A. Ghanekar, I. McGilvray, D. Grant, G. Sapisochin, J. Dang, A. Poonja, W. Sun, D. Bigam, D. Birch, S. Karmali, S. Patel, C. Garcia-Ochoa, D. Breadner, S. Welch, K. Leslie, D. Skubleny, D. Rayner, N. Kneteman, S. Cleary, M. Kendrick, H. Smith, A. Davis, J. Abou-Khalil, G. Martel, F. Balaa, K. Bertens, L. Park, D. Mergui, J. Pelletier, T. Vanounou, M. Guttman, V. 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Sutherland, S. Minor, M. Mainprize, M. Mainprize, A. Doumouras, S. Gmora, M. Anvari, D. Hong, D. Khalil, R. Villiard, P. Koch, L. Windisch, M. Pyarali, A. Doumouras, D. Hong, J. Dang, A. Modasi, S. Byrns, N. Switzer, D. Birch, S. Karmali, A. Maeda, S. MacLellan, A. Vergis, A. Okrainec, T. Jackson, A. Sharples, K. Hardy, B. Zevin, J. Dang, N. Switzer, D. Birch, S. Karmali, D. Smith, V. Mocanu, N. Switzer, D. Birch, S. Karmali, N. Slater, S. Malik, N. Hanna, T. Bao, B. Zevin, Y. Lee, K. Tikkinen, M. Pedziwiatr, P. Major, I. Aditya, Y. Krakowsky, A. Doumouras, S. Gmora, M. Anvari, D. Hong, Y. Lee, J. Dang, N. Switzer, D. Birch, S. Karmali, H. Cheah, K. Wong, C. Stockley, K. Wong, K. Wong, N. Dalgarno, M. Martin, C. Grady, R. Houlden, R. Birtwhistle, K. Smith, R. Morkem, D. Barber, J. Dang, N. Switzer, A. Sharma, D. Birch, S. Karmali, V. Mocanu, A. MacDonald, J. Dang, N. Switzer, D. Birch, S. Karmali, J. Dang, N. Switzer, J. Kung, S. Karmali, D. Birch, A. Mann, D. Hong, M. Anvari, G. Babe, K. Dehghan, C. Reimer, D. Robertson, B. Zevin, J. Dang, N. Switzer, D. Birch, S. Karmali, J. Choi, K. Clouston, A. Vergis, K. Hardy
Institutions: University of British Columbia, University of Toronto, University of Manitoba, McGill University, Columbia University, University of Alberta, University of Calgary, Western University, University of Limerick, McMaster University, Royal College of Surgeons in Ireland, Mayo Clinic, LAC+USC Medical Center, University of Ottawa, Dalhousie University, Memorial University of Newfoundland, Canadian Association of General Surgeons, University of Saskatchewan, NOSM University, Royal College of Physicians and Surgeons of Canada, Vancouver General Hospital, St. Michael's Hospital, University of Guelph, Queen's University, Ottawa Hospital, Indiana University Bloomington, McGill University Health Centre, Central Coast Local Health District, Hokkaido University, St Mary's Hospital Centre, IRCCS Ospedale San Raffaele, Universidade Federal de São Paulo, Université de Montréal, London Health Sciences Centre, Institute for Clinical Evaluative Sciences, George & Fay Yee Centre for Healthcare Innovation, University of Southern California, University of California, Los Angeles, Ottawa Hospital Research Institute, Ottawa Heart Institute, The University of Texas at Austin, National University of Singapore, Singapore General Hospital, Sunnybrook Health Science Centre, University Health Network, Carleton University, BC Cancer Agency, London School of Economics and Political Science, University of Padua, William Osler Health System, St. Paul's Hospital, Providence Health Care, Centre Hospitalier de l’Université de Montréal, Jewish General Hospital, Johns Hopkins University, Johns Hopkins Medicine, Université Laval, Sunnybrook Research Institute, Université de Sherbrooke, Laurentian University, Northwestern University, St. Joseph’s Healthcare Hamilton, St James's University Hospital, Ospedale Maggiore Carlo Alberto Pizzardi, Azienda Ospedaliera San Gerardo, Fox Chase Cancer Center, Cancer Care Ontario, Alberta Health Services, Leiden University, Harvard University, Leiden University Medical Center, Institut Gustave Roussy, The Netherlands Cancer Institute, Dana-Farber Cancer Institute, Royal Marsden Hospital, Institut Bergonié, Dana-Farber/Harvard Cancer Center, The Maria Sklodowska-Curie National Research Institute of Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Institut Curie, Sunnybrook Hospital, University of Kansas, Memorial Sloan Kettering Cancer Center, Centre intégré de santé et de services sociaux de Lanaudière, The Ohio State University, Jagiellonian University, University of Helsinki, Gosford Hospital
Language: English
Open Access status: hybrid
OpenAlex ID: W4230606242