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A laddered training model for breast surgery specialists: development and validation of a CBME-based precision
Kailun Xu1, Lingting Jiang2, Yun Zhang2
1Department of Breast Surgery and Oncology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
BMC Medical Education
|June 19, 2026
Summary
A new stepwise training model significantly improved breast surgery residents' skills in biopsies, port implantation, and surgery. This competency-based approach enhances operative performance and patient management for better surgical training outcomes.
Area of Science:
- Medical Education
- Surgical Training
- Breast Surgery
Background:
- Competency-Based Medical Education (CBME) is crucial for surgical training.
- Standardized training models are needed to enhance resident skills in breast surgery.
- Improving operative skills, clinical decision-making, and patient management are key goals.
Purpose of the Study:
- To develop and evaluate a stepwise training model for breast surgery residents.
- To assess the model's efficacy within a CBME framework.
- To improve surgical competencies and patient care.
Main Methods:
- A 6-month stepwise training program with three levels: basic skills, minor procedures, and advanced procedures.
- Twenty residents were randomized into an experimental (stepwise training) and control (conventional training) group.
- Outcomes measured included biopsy concordance, port implantation success, and operative time for breast-conserving surgery.
Main Results:
- The experimental group showed a significantly higher pathological concordance rate for mass puncture biopsies (98.0% vs. 86.0%).
- Catheterization success rate for venous access port implantation was significantly higher in the experimental group (96% vs. 80%).
- Supervised breast-conserving surgery operative time was significantly shorter in the experimental group (120 min vs. 180 min).
Conclusions:
- The stepwise training model effectively enhanced clinical competencies and surgical performance in breast surgery residents.
- This structured, competency-based approach leads to improved training outcomes.
- The model provides a scalable and effective pathway for specialized breast surgery training.