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Updated: May 21, 2025

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Implementation of a Competency-Based Training Program in Pediatric Surgery: A Pilot Study.

Rebecca Moreci1, Brianna Spencer2, Brian Fallon3

  • 1Section of Pediatric Surgery, Department of Surgery, University of Michigan Medical School, C.S. Mott Children's Hospital, Ann Arbor, MI, USA.

Journal of Pediatric Surgery
|March 22, 2025
PubMed
Summary
This summary is machine-generated.

Competency-based training (CBT) in pediatric surgery enhances fellow autonomy and competence. This pilot program successfully prepared fellows for faculty roles by providing structured, individualized skill development and assessment.

Keywords:
AutonomyCompetency-based trainingPediatric surgery fellowshipSurgical education

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Area of Science:

  • Medical Education
  • Surgical Training
  • Pediatric Surgery

Background:

  • Surgical trainees historically experience limited autonomy.
  • Graduated autonomy integrated into fellowship programming can enhance trainee competence.
  • A pilot study aimed to implement a competency-based training (CBT) approach in pediatric surgery fellowship.

Purpose of the Study:

  • To pilot a competency-based training (CBT) approach for pediatric surgery fellowship programs.
  • To demonstrate flexibility for individualized learning paces.
  • To facilitate increased fellow autonomy through assessed competence.

Main Methods:

  • A CBT program was developed with five components: operative evaluations, communication assessment tool (CAT), entrustable professional activities (EPAs), oral exams, and video reviews.
  • Fellow progression was tracked through a clinical competency committee (CCC) review.
  • Program changes and fellow participation were monitored over several years.

Main Results:

  • Six fellows completed the program between 2017 and 2023, achieving competency in 1-4 procedures.
  • Fellows reported satisfaction with the CBT structure, noting enhanced independence and preparedness for faculty roles.
  • The program's structured format facilitated graduated autonomy, a key strength.

Conclusions:

  • Competency-based training (CBT) effectively identifies knowledge and skill gaps, supporting progressive autonomy in trainees.
  • Further research is needed to generate validity evidence and support program dissemination.
  • The pilot demonstrated CBT's potential to improve pediatric surgery fellowship training.