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Training initiative list scheme (TILS) for minimal access therapy: the MATTUS experience
A Cuschieri1, R G Wilson, G Sunderland
1Surgical Skills Unit, Ninewells Hospital & Medical School Dundee, UK.
Journal of the Royal College of Surgeons of Edinburgh
|November 14, 1997
Summary
The Training Initiative List Scheme (TILS) successfully funded minimal access therapy (MAT) training in Scotland. Audits show the scheme is viable, cost-effective, and does not compromise patient safety during surgical training.
Area of Science:
- Surgical Education
- Medical Training Audits
- Healthcare Management
Background:
- Minimal Access Therapy (MAT) training requires dedicated resources.
- Existing training models may not adequately support specialized surgical skills development.
- The MATTUS intercollegiate exercise aimed to address these gaps.
Purpose of the Study:
- To establish and audit a Training Initiative List Scheme (TILS) for funding minimal access therapy (MAT) operative sessions.
- To assess the operational and educational viability of TILS.
- To evaluate the impact of TILS on patient outcomes and training effectiveness.
Main Methods:
- A prospective, centralized audit of TILS was conducted across nine Scottish Trust hospitals over 12 months.
- The audit tracked 510 contracted training sessions for MAT, minimal access surgery (MAS), flexible endoscopy, and interventional radiology.
- Key outcome measures included trainee completion rates, conversion rates, morbidity, mortality, and trainee/trainer assessments.
Main Results:
- 95% of contracted sessions were completed, with 463 audited.
- 817 operations/procedures were performed, with trainees as the principal operator in 82% and successful completion in 74%.
- Trainee performance was rated highly by tutors (87% excellent/good), and 99% of sessions were rated excellent/good by trainees. Patient outcomes were not compromised, with 5% post-operative complications and no training-related deaths.
Conclusions:
- The Training Initiative List Scheme (TILS) is operationally and educationally viable for unhurried MAT training.
- The scheme can be implemented within a pre-determined budget.
- TILS effectively facilitates surgical training without compromising immediate patient clinical outcomes.
