>Cirugía y Cirujanos
>Year 2011, Issue 1
Fingerhut A, Veyrie N, Millat B, Leandros E
Education and teaching laparoscopic surgery in europe: present constraints and role of the european association for endoscopic surgery
Cir Cir 2011; 79 (1)
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As we move on to the second decade of the 21st century, many changes in education and, particularly, in training future surgeons, have come to pass. Several of these changes are the result of a natural evolution in teaching methods, but others have been dictated by global modifications in the educational and social systems reigning throughout the Western culture. The recent evolution to less aggressive therapy and, in particular, surgical techniques, attests to the desire to decrease patient harm. Laparoscopic surgery based on less invasive parietal violation and insult, responding to the above-mentioned concerns, has rekindled the debate on patient safety but also has opened the debate on how to best teach the technique. This paper endeavors to describe the problems created by the social and economic changes in the last few decades, to assess the consequences on teaching and learning laparoscopic surgery for the surgeon and to review possible solutions.
||Laparoscopic surgery, surgical education.
The Council of the European Union. Council Directive 93/104/EC of 23 November 1993 concerning certain aspects of the organization of working time. Disponible en http:www.fve.org/veterinary/pdf/profession/directive_93_104_ec.pdf
Rosenthal R, Gantert WA, Hamel C, Metzger J, Kocher T, Vogelbach P, et al. The future of patient safety: surgical trainees accept virtual reality as a new training tool. Patient Safety Surg 2008;2:16.
Babineau TJ, Becker J, Gibbons G, Sentovich S, Hess D, Robertson S, et al. The ìcostî of operative training for surgical residents. Arch Surg 2004;139:366-370.
Barshes NR, Vavra AK, Miller A, Brunicardi FC, Goss JA, Sweeney JF. General surgery as a career: a contemporary review of factors central to medical student specialty choice. J Am Coll Surg 2004;199:792-799.
Campbell B, Patrick H, Barnes S, Marlow M. How should accredited specialists be trained to do new procedures? Ann R Coll Surg Engl 2009;91:91-94.
Richards T. Running out of time. BMJ 2009;338(1507):914-915.
Halsted WS. The training of the surgeon. Bull Johns Hopkins Hosp 1904;15:267-275.
Jackson GP, Tarpley JL. How long does it take to train a surgeon? BMJ 2009;339:1062-1064.
Pappas T. A debt unpaid, remembering David Coston Sabiston. Ann Surg 2009;249:706-707.
Fletcher KE, Davis SQ, Underwood W, Mangrulkar R, McMahon LF, Saint S. Systematic review: effects of resident work hours on patient safety. Ann Intern Med 2004;141:851-857.
Fletcher KE, Underwood W, Davis SQ, Mangrulkar RS, McMahon LF, Saint S. Effects of work hour reduction on resident’s lives: a systematic review. JAMA 2005;294:1088-1100.
Curet MJ. Resident work hour restrictions: where are we now? J Am Coll Surg 2008;207:767-776.
Carlin AM, Gasevic E, Shepard AD. Effect of the 80-hour work week on resident operative experience in general surgery. Am J Surg 2007;193:326-330.
Chung RS. How much time do surgical residents need to learn operative surgery? Am J Surg 2005;190:351-353.
Feanny MA, Scott BG, Mattox KL, Hirshberg A. Impact of the 80-hour work week on resident emergency operative experience. Am J Surg 2005;190:947-949.
Jarman BT, Miller MR, Brown RS, Armen SB, Bozaan AG, Ho GT, et al. The 80-hour work week: will we have less-experienced graduating surgeons? Curr Surg 2004;61:612-615.
Baskies MA, Ruchelsman DE, Capeci CM, Zukerman JD, Egol KA. Operative experience in an orthopaedic surgery residency program: the effect of work-hour restrictions. J Bone Joint Surg Am 2008;90:924-927.
Dozois EJ, Holubar SD, Tsikitis VL, Malireddy K, Cima RR, Farley DR, et al. Perceived impact of the 80-hour workweek: five years later. J Surg Res 2009;156:3-15.
Bland KI, Stoll DA, Richardson JD, Britt LD. Brief communication of the Residency Review Committee-Surgery (RRC-S) on residents’ surgical volume in general surgery. Am J Surg 2005;190:345-350.
Gelfand DV, Podnos YD, Carmichael JC, Saltzman DJ, Wilson SE, Williams RA. Effect of the 80-hour work week on resident burnout. Arch Surg 2004;139:933-938.
Spencer AU, Teitelbaum DH. Impact of work hour restrictions on residents’ operative volume on a subspecialty surgical service J Am Coll Surg 2005;200:670-676.
Landrigan CP, Rothschild JM, Cronin JW, Kaushai R, Burdick E, Katz JT, et al. Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med 2004;351:1838-1848.
Antiel RM, Thompson SM, Reed DA, James KM, Tilburt JC, Bannon MP, et al. ACGME Duty-Hour Recommendations—A National Survey of Residency Program Directors. N Engl J Med 2010;363:e12.
Bollschweiler E, Krings A, Fuchs KH, Pistorius G, Bein T, Otto U, et al. Alternative shift models and the quality of patient care. An empirical study in surgical intensive care units. Langenbecks Arch Surg 2001;386:104-109.
Poulose BK, Ray WA, Arbogast PG, Needleman J, Buerhaus PI, Griffin MR, et al. Resident work hour limits and patient safety. Ann Surg 2005;241:847-856.
Salim A, Teixeira PGR, Chan L, Oncel D, Inaba K, Brown C, et al. Impact of the 80-hour work week on patient care at a level I trauma center. Arch Surg 2007;142:708-714.
Yaghoubian A, Saltmarsh G, Rosing DK, Lewis RJ, Stabile BE, de Virgilio C. Decreased bile duct injury rate during laparoscopic cholecystectomy in the era of the 80 hour resident workweek. Arch Surg 2008;143:847-851.
Kelz RR, Morris JB. Patient safety and surgical training. An unhealthy relationship? N Engl J Med 2009;249:877-878.
Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J. Laparoscopic performance after one night on call in a surgical department: prospective study. BMJ 2001;323:1222-1223.
Carpenter RO, Austin MT, Tarpley JL, Griffin MR, Lomis KD. 18 Work-hour restrictions as an ethical dilemma for residents. Am J Surg 2006;191:527-532.
Beley S, Dubosq F, Simon P, Larre S, Battisti S, Ballereau C, et al. Improvement of the recruitment of surgery interns derived from the Epreuves Nationales Classantes (National-Ranking Exam): practical solution applied to urology. Prog Urol 2005;15:1101-1105.
Bruyere F, d’Arcier BF, Lanson Y. Reasons for the choice of urology by residents. Prog Urol 2005;15:681-683.
Doan BD, Levy D, Pavot J. Demographic forecasts of medical workforce supply in France (2000-2050). What numerus clausus for what future? Cah Sociol Demogr Med 2004;44:101-148.
Lanson Y. Lack of interest in general practice during the National Ranking Examination in 2005. Presse Med 2006;35:407-412.
Pellegrini CA, Warshaw AL, Debas HT. Residency training in surgery in the 21st century: a new paradigm. Surgery 2004;136:953-965.
Lefevre JH, Roupret M, Kerneis S, Karila L. Career choices of medical students: a national survey of 1780 students. Med Educ 2010;44:603-612
Borman KR, Vick LR, Biester TW, Mitchell ME. Changing demographics of residents choosing fellowships: longterm data from the American Board of Surgery. J Am Coll Surg 2008;206:782-788.
Denekens JP. The impact of feminisation on general practice. Acta Clin Belg 2002;57:5-10.
Maiorova T, Stevens F, van der Zee J, Boode B, Scherpbier A. Shortages in general practice despite feminisation of medicine: a seeming paradox? A cohort study. BMC Health Serv Res 2008;8:262.
McKinstry B, Colthart I, Elliott K, Hunter C. The feminization of the medical work force, implications for Scottish primary care: a survey of Scottish general practitioners. BMC Health Serv Res 2006;6:56.
Baxter N, Cohen R, McLeod R. The impact of gender on the choice of surgery as a career. Am J Surg 1996;172:373-376.
Maggiori L, Brouquet A, Zeitoun JD, Roupret M, Lefevre JH. The future of gastrointestinal surgery in France: national survey of 929 medical students and results of professional choices after the 2008 national ranking exam. J Chir 2009;146:168-174.
Arnold MW, Patterson AF, Tang AS. Has implementation of the 80- hour work week made a career in surgery more appealing to medical students? Am J Surg 2005;189:129-133.
Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med 2005;142:260-273.
Millat B, Fingerhut A, Cuschieri A. Live surgery and video presentations: seeing is believing... but no more: a plea for structured rigor and ethical considerations. Surg Endosc 2006;20:845-847.
Fields RC, Bowman MC, Freeman BD, Klingensmith ME. Implementation of an “after hours” resident educational program in a general surgery residency: a paradigm for increasing formal didactic training outside of the hospital setting in the era of the 80-hour workweek. J Surg Educ 2009;66:340-343.
Jakimowicz J, Fingerhut A. Simulation in surgery. Br J Surg 2009;96:563-564.
Ericsson KA, Krampe RT, Tesch-Romer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev 1993;100:363-406.
Reznick RK, MacRae H. Teaching surgical skills—changes in the wind. N Engl J Med 2006;355:2664-2669.
Andreatta PB, Woodrum DT, Birkmeyer JD, Yellamanchilli RK, Doherty GM, Gauger PG, et al. Laparoscopic skills are improved with LapMentorô training: results of a randomized, double-blinded study. Ann Surg 2006;243:854-863.
Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jansen P. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 2004;91:146-150.
Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, et al. Virtual reality training improves operating room performance results of a randomized, double-blinded study. Ann Surg 2002;236:458-464.
Gurusamy KS, Aggarwal R, Palanivelu L, Davidson BR. Virtual reality training for surgical trainees in laparoscopic surgery. Cochrane Database of Systematic Reviews, 2009, Issue 1.
Roberts KE, Bell RL, Duffy AL. Evolution of surgical skills training. World J Gastroenterol 2006;12:3219-3224.
>Cirugía y Cirujanos
>Year 2011, Issue 1