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Defining the acute care surgery curriculum.

Therese M Duane1, Christopher J Dente, John J Fildes

  • 1From the JPS Health Network (T.M.D.), Fort Worth, Texas; Emory University (C.J.D.), Atlanta, Georgia; University of Nevada School of Medicine (J.J.F.), Las Vegas, Nevada; Yale University (K.A.D.), New Haven, Connecticut; Denver Health Medical Center (G.J.J.), Denver, Colorado; Wake Forest Baptist Medical Center (J.W.M.), Winston-Salem, North Carolina; and Eastern Virginia Medical School (L.D.B.), Norfolk, Virginia.

The Journal of Trauma and Acute Care Surgery
|March 11, 2015
PubMed
Summary

Acute care surgery (ACS) trainees show significant gaps in essential and desirable case experience, particularly in head/neck and pediatric procedures. Reevaluating the ACS curriculum and training modalities is recommended to address these deficiencies.

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Area of Science:

  • Surgical Education
  • Acute Care Surgery Training
  • Medical Curriculum Development

Background:

  • The study aimed to identify deficiencies in essential and desirable (E/D) case volumes within the Acute Care Surgery (ACS) curriculum.
  • Understanding these gaps is crucial for potential curriculum reevaluation and training restructuring.

Purpose of the Study:

  • To define the specific gaps in essential and desirable case volumes for Acute Care Surgery (ACS) trainees.
  • To provide data that may prompt reevaluation of the ACS curriculum and training structure.

Main Methods:

  • A review of ACS trainee case logs from July 2011 to June 2013 was conducted.
  • Trainee logs were analyzed for the frequency of performing cases listed on the E/D list, using Current Procedural Terminology (CPT) codes mapped to the E/D list.

Main Results:

  • Analysis included 487 fellow-months of data, with trainees logging more E/D list cases (175.5/year) than non-E/D list cases (143.5/year).
  • Common essential cases included laparotomy for trauma, tracheostomy, and gastrostomy tubes.
  • A significant finding was that 16 distinct E/D codes (13.6%) were never used by any fellow, with notable omissions in head/face, neck, thoracic vascular trauma, and pediatric procedures.

Conclusions:

  • Current ACS trainees demonstrate inadequate experience in head/neck and pediatric procedures as per the ACS curriculum standards.
  • Restructuring rotations and exploring novel educational methods are suggested to enhance trainee exposure.
  • Reevaluation of the existing ACS curriculum is warranted to address identified experience gaps.