General surgery primary operator rates: a guide to achieving future competency

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Excerpt

Competency at the completion of surgical training is a topic of much discussion in recent times, with debate regarding the adequacy of current training schemes to achieve competent surgeons.1 An emphasis has always been placed upon caseload and experience gained by the individual during their training, with a consensus that the greater the caseload, the more competent the trainee. Most training programmes use total caseload to assess technical expertise. The surgical education and training (SET) programme for general surgery trainees in Australia, a programme that comprises 4–5 years of specialty education, emphasizes primary operator rates as a major tool to determine an individual's progression through training.3
The development of psychomotor skills during surgical training was thought to be developed through reactive learning but is now strongly felt to be driven by proactive mentoring.4 It is perhaps this shift in educational beliefs that has led people away from the model of caseload and operative experience alone being adequate enough to progress trainees towards competency.
The objective of this study was to identify trends between trainees’ primary operator experience and training level, with the aim to determine whether achieving a specified number of procedures correlated with competency and progression through training. We hoped to assess the current state of surgical training and be able to identify gaps in education that need addressing.
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