In the past 50 years, continuing education in surgery has come a long way. People now agree that surgical education should be ongoing and never stop. There are several ways to do this. There are three important things to think about. Among these are the evaluation of CPD and PBLI activities, training for surgical fellowships, and quality collaboratives.
In the second half of the 20th century, most of the surgery improvements came from lab science. The American College of Surgeons' Journal of Surgery said that lab discoveries took up a third of its pages in the 1950s and 1960s.
In the last 100 years, there have been many advances in surgery, such as the use of anesthesia, the invention of the first operating microscope, the use of rubber gloves to protect the surgeon from getting an infection, and the creation of the windlass tourniquet. These improvements helped make surgery safer and less painful.
In the early 1800s, surgery was very painful and scary. Before anesthetics were used in Europe, surgeons couldn't deal with pain or infections. But when anesthetics were invented, surgeons could do more complicated and even more invasive procedures.
In 1954, the first known living donor kidney transplant took place. Massive ovarian cysts were removed during the first successful bilateral ovariotomy. Citrate was added to the blood to make a new type of blood transfusion, which was also a big step forward.
In Canada, surgical fellowship training may not be as common as in the U.S. But more and more residents are choosing this type of training. There are also other things to think about. Especially the role of the fellow in the operating room needs to be better explained.
This is a hard problem to solve. As with any specialized training, the role of the fellow may change from one hospital to the next. A clinical fellow's duties can range from helping doctors to leading medical teams to doing research.
The best fellowship programs usually have a curriculum based on the trainee's needs. This is especially true in the spine field, where there are different levels of clinical exposure, procedure knowledge, and the need to keep learning.
The South Carolina Surgical Quality Collaborative (SC SQC) is a all-encompassing program based on data. It focuses on high-volume, high-risk surgeries. It has ambulatory surgery centers and big academic centers as members. They work together with leaders in surgical care from all over the state. It was written about in an article for the Journal of the American College of Surgeons.
In Canada, residency training is often followed by fellowship training. It usually takes one or two years. A typical program will have an MCQ test, teaching sessions, and interprofessionalism. But there are no national rules about which programs are best.
Surgical quality collaboratives are a way to improve the quality of care for people who are going to have surgery. Healthcare providers, surgical societies, and payers are all part of these groups. They include finding the best ways to do things, getting formal training, and helping to fund local projects.
In 2014, the Illinois Surgical Quality Improvement Collaborative (ISQIC) came into being. 55 hospitals and several community hospitals are part of the collaborative. The group has been able to improve the care that patients get. Its goals include making patients safer and saving money by getting rid of procedures that aren't needed.
Participating hospitals saw an improvement in the quality of surgery, a decrease in surgical complications, and a drop in deaths after surgery. They also avoided spending millions of dollars more than they needed to.
Whether a surgeon is new to surgery or has been doing it for years, continuous professional development (CPD) can be an important way to meet their learning needs. Continuous professional development can also make patient care better. But how do we evaluate CPD and activities for practice-based learning and improvement (PBLI)?
One way to evaluate CPD and PBLI activities is to determine which results are most important to doctors. The results of these assessments can be used to plan for the future.
Patient's health is the most important outcome, followed by better clinical outcomes and learning for healthcare professionals. Other results include patients and healthcare workers' health and safety. These results can be measured with referral patterns, how prescriptions are written, and how often clinic staff are available.
Practice-based learning and improvement (PBLI) is a cycle that includes four steps: learning, self-assessment, putting new knowledge into practice and checking for improvement. The ACGME has made a tool to help with PBLI competency evaluation.