The Simulators Prominent Role in Assessing Vascular Surgery Residents
The traditional surgical training methods in The Netherlands have changed, and new methods were required to train and assess vascular surgery residents.
Prof. Bob Geelkerken, Consultant Vascular Surgeon, University of Twente, former chair of Dutch Society of Vascular Surgery.
“When I was trained as a vascular surgeon, the ‘See one, do one, teach one’ principle was used, and at a certain moment your professor said: OK, the next operation is for you, and then he looked over your shoulder and said, it’s ok, next time you can call me if you are in trouble. The complexity of operations increased enormously, and this kind of training is no longer allowed.”
“We had to change the training curriculum in 2007. Residents first assist in an operation, then do small parts of the operation under direct supervision. Later, most of the essential parts of the operation are performed under direct supervision and only thereafter the residents are allowed to operate independently. So it’s much more stepwise and a lot of more time for trainers to train their residents. In the new curriculum, there was an obligation that we assess residents after completing the curriculum.”
During the past nine years, ANGIO Mentor endovascular simulators have been utilized for the CASH-3 Vascular Course at the University of Twente, The Netherlands. The course is a collaboration between the Dutch Society of Vascular Surgery and the University of Twente.
“We started the training and assessment course, where residents demonstrate their knowledge and skills in a stressful situation using the ANGIO Mentor simulators,” said Prof. Geelkerken.
The CASH-3 Vascular is a two-day course for vascular surgery residents that can be used as preparation for the European vascular exam. The course is obligatory for Dutch residents in vascular surgery, but is also open for other specialists. During the course residents are assessed on different topics that are part of the Dutch surgical curriculum. Prior to assessment, trainees go through a structured process including e-learning, pre-testing, practical case-specific assessments and learning progress tracking.
Dr. Maarten van der Laan, CASH-3 course proctor, vascular surgeon and program director, head of skills center and simulation in surgery, University Medical Center, Groningen:
“We can see how the students are performing, how their skills are, how their approach is, if they can demonstrate how they step-by-step build up the case and build up the treatment. On one hand they can demonstrate if they are able to work safely an on the other hand we can assess if they can treat unexpected circumstances.”
To be able to use it in assessment, we need to be able to rely on the performance of the simulators and also the support behind the product. The close collaboration that we have with the Surgical Science simulation team from Surgical Science is something that’s very important to us.
Sebastiaan Waanders, Head of Infrastructure, Technical Medical Center (TechMed), University of Twente
It’s the next best thing from the real patient, so it’s a very good opportunity to present your skills on such a simulator. Gerdine von Meijenfeldt, Vascular Surgery Resident
“One of the outcomes of this nationwide course we are doing for nine years is that the level of (endo)vascular knowledge and skills (competencies) in all regions in the Netherlands is clearly improved and equalized. In addition, nowadays, during the examinations of the European board of Vascular Surgery, the Dutch residents are always the top 10, because just before the board examination they have the CASH-3 training and assessment course, and it really helps them in becoming skilled and clever” said Prof. Geelkerken.