INDIANAPOLIS — A new approach to training young surgeons will ensure the safety of patients and preserve Indiana University School of Medicine’s reputation for excellence and innovation in the operating room for years to come.
The IU Department of Surgery program is one of just two in the nation to require surgical residents to prove they are skilled at a procedure before they are allowed to perform it on a patient. Residents must first attend sessions and practice the techniques in the newly opened Surgical Skills Training Center. Next, residents are videotaped and their technique is evaluated by a practicing surgeon. No surgical resident can enter the operating room to perform a procedure without first passing the proficiency test.
The program is at the heart of a curriculum developed by Gary Dunnington, M.D., who became chairman of the IU Department of Surgery in July 2012 and is an internationally recognized surgical educator. His goal as the new chair of surgery was to establish a verifiable proficiency model curriculum at Indiana University, similar to the first program in the nation, which he established at the University of Southern Illinois in 2005.
“My vision was to create a surgical skills training platform that is the best way to teach the various skills surgeons need in the operating room. Those skills include the basics, such as suturing and knot tying, as well as virtual surgery techniques and, finally, team-based training for the ultimate environment — a high-tech, busy operating room,” said Dr. Dunnington.
The boot camps, as they are called, start with the basics, for which proficiency tests are required even though many of the residents may have practiced them as medical students. Typically, boot camps are on Friday mornings when the residents learn the fine points of various procedures taught by surgical faculty who specialize in those procedures. The skills lab is open for practice other days of the week.
The curriculum is divided into 13-week segments. The first segment covers basic skills in each of the surgical specialties: urology, plastic, vascular, general, transplant and cardiovascular-thoracic. The residents then progress to entire operations, while receiving laparoscopic and virtual reality training. The final phase teaches surgeons to be highly effective leaders in the operating room with training on how to lead a surgical team.
“I think the public wants to feel like they’re not being experimented on, and they like to hear that surgeons-in-training have demonstrated a level of proficiency before they touch a patient,” said Don J. Selzer, M.D., associate professor of surgery and director of the Surgical Skills Training Center. “The goal of this is to expose patients to as little of the learning curve as possible.”
The Surgical Skills Training Center, which was built in record time at a cost of $1 million, was made possible by the dedication of the faculty and the school’s leadership. Forty faculty members agreed to take time away from the operating room to participate in the lab training sessions for the 95 current residents and fellows who are completing their surgical residency at IU.
“It’s nice to be in a low-stress environment where there isn’t a real person,” said first-year resident Bryan Carr, M.D.
“There was a sense at Indiana University that this was the right time for the proficiency-based program to be initiated,” Dr. Dunnington said. “At IU, no surgical resident will step into the operating room unprepared.”