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Changing Education Paradigms: Training Transplant Fellows for High Stake Procedures.
Rice, Teresa C; Kassam, Al-Faraaz; Lewis, Hannah V; Hobeika, Mark; Cuffy, Madison C; Ratner, Lloyd E; Diwan, Tayyab S.
Afiliación
  • Rice TC; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, Ohio.
  • Kassam AF; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, Ohio.
  • Lewis HV; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, Ohio.
  • Hobeika M; J.C. Walter, Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas.
  • Cuffy MC; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, Ohio.
  • Ratner LE; Department of Surgery, Division of Transplantation, Columbia University, New York, New York.
  • Diwan TS; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, Ohio. Electronic address: diwantb@ucmail.uc.edu.
J Surg Educ ; 77(4): 830-836, 2020.
Article en En | MEDLINE | ID: mdl-32067900
OBJECTIVE: Living kidney donation is a unique operation, as healthy patients are placed at risks inherent with major surgery without physical benefit. The ethical implications associated with any morbidity make it a high-stakes procedure. Fellowships are faced with the dilemma of optimizing fellow training in this demanding procedure while providing safe outcomes to donors. The Laparoscopic Living Donor Nephrectomy (LDN) Workshop is a resource that can provide intense instruction to help bridge the training deficit. Our aim was to examine the course's effectiveness in improving fellows' skill and confidence related to implementing LDN into future practice. METHODS: From 2017 to 2018, 36 abdominal transplant surgery fellows participated in a 2-day workshop consisting of live surgery observation, cadaver lab, and didactic sessions. Surveys were completed precourse, postcourse, and at 3-month postcourse follow-up. RESULTS: Preworkshop, 61% of participants reported less than 50% confidence in independent performance of LDN. Following workshop completion, 95% reported improved confidence. At 3-month follow-up, there was a 30% (p < 0.05) increase in median confidence level. Immediately following the course, 67% reported improved ability to analyze kidneys prior to donation, 74% changed the way donor candidates were evaluated, and 67% reported enhanced ability to risk stratify donors. Eighty-five percent felt it strengthened operative techniques with 70% implementing new diagnostic treatments and surgical strategies. Seventy percent of participants felt it improved their communication with colleagues and 67% had enhanced communication with patients. These trends were maintained at 3-month follow-up. CONCLUSION: These results indicated that the LDN Workshop improves confidence and increases fellows' skillset in a high-stakes procedure. The LDN Workshop is a useful adjunct to fellowship training to optimize successful, efficient, and safe performance of a demanding procedure in a uniquely healthy donor population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Becas Aspecto: Ethics Límite: Humans Idioma: En Revista: J Surg Educ Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Becas Aspecto: Ethics Límite: Humans Idioma: En Revista: J Surg Educ Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos