Changing Education Paradigms: Training Transplant Fellows for High Stake Procedures

Area of Science:

• Transplant Surgery
• Surgical Education
• Nephrology

Background:

• Living kidney donation involves significant surgical risks for healthy donors without direct benefit.
• Optimizing fellow training in living donor nephrectomy (LDN) while ensuring donor safety presents an ethical challenge.
• Fellowship programs require effective methods to bridge training gaps in complex procedures like LDN.

Purpose of the Study:

• To evaluate the effectiveness of a Laparoscopic Living Donor Nephrectomy (LDN) Workshop.
• To assess improvements in surgical fellows' skills and confidence in performing LDN.
• To determine the workshop's impact on fellows' future practice of LDN.

Main Methods:

• A 2-day workshop including live surgery observation, cadaver lab, and didactic sessions.
• 36 abdominal transplant surgery fellows participated from 2017 to 2018.
• Surveys were administered pre-workshop, post-workshop, and at 3-month follow-up.

Main Results:

• Confidence in performing LDN increased from 61% (less than 50% confidence) pre-workshop to 95% post-workshop, with a sustained 30% increase at 3 months.
• Significant improvements were reported in evaluating donor candidates, risk stratification, and operative techniques.
• Enhanced communication skills with colleagues and patients were noted, with 70% and 67% reporting improvements, respectively.

Conclusions:

• The LDN Workshop effectively enhances fellows' confidence and skillset for performing living donor nephrectomy.
• The workshop serves as a valuable adjunct to fellowship training, promoting safe and efficient LDN.
• Improved training in LDN contributes to better outcomes for the unique population of living kidney donors.